Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain.
Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Drug Alcohol Depend. 2021 Aug 1;225:108793. doi: 10.1016/j.drugalcdep.2021.108793. Epub 2021 May 29.
Tranquilizer misuse represents a growing international public health problem with heavy social and economic consequences. We aimed to identify the psychosocial determinants of this misuse practice, focusing on modifiable factors including knowledge and attitudes towards these medications.
A prospective cohort study involving 847 adults accompanying children in primary care clinics was carried out in Spain. A validated Knowledge, Attitudes and Practices (KAP) questionnaire on tranquilizer use was self-administered at baseline, and then participants were followed-up bimonthly. A misuse event was defined as unprescribed intake of tranquilizers, storing/sharing leftovers of tranquilizers, and/or not adhering to the prescribed treatment period, timing or dosage. Poisson regression models were applied to estimate adjusted Incidence Rate Ratios (IRRs) of misuse and their 95 % Confidence Intervals (CIs).
Individuals' personal attitudes towards tranquilizers and treating physicians are strongly associated with the misuse of these drugs. These attitudes include: individuals' acceptance of taking tranquilizers to improve sleeping [IRR: 5.10 (95 %CI: 2.74-9.48)], to work better [IRR: 2.04 (95 %CI: 1.05-3.99)], or for recreational purposes [IRR: 1.85 (95 %CI: 1.04-3.32)]; willingness to prolong the course of tranquilizer treatment without medical consultation [IRR: 2.45 (95 %CI: 1.46-4.13)]; agreeing on storing tranquilizers for possible future need [IRR: 5.07 (95 %CI: 2.73-9.40)]; and untrusting the physician's decision about tranquilizer prescription [IRR: 1.92 (95 %CI: 1.12-3.30)]. The level of knowledge is marginally associated with tranquilizer misuse.
There is a strong association between individuals' attitudes towards tranquilizers and the misuse practices of these drugs. Educational interventional studies could help reduce the incidence of tranquilizer misuse.
镇静剂滥用是一个日益严重的国际公共卫生问题，会带来严重的社会和经济后果。我们旨在确定这种滥用行为的心理社会决定因素，重点关注包括对这些药物的知识和态度在内的可改变因素。
在西班牙的初级保健诊所，我们进行了一项涉及 847 名成年人的前瞻性队列研究。在基线时，他们自行完成了一份关于镇静剂使用的经过验证的知识、态度和实践（KAP）问卷，然后每两个月对参与者进行一次随访。将未处方摄入镇静剂、储存/分享镇静剂的剩余部分以及/或不遵守规定的治疗期限、时间或剂量定义为滥用事件。应用泊松回归模型估计滥用的调整发病率比（IRR）及其 95%置信区间（CI）。
个人对镇静剂和治疗医生的个人态度与这些药物的滥用密切相关。这些态度包括：个人接受服用镇静剂来改善睡眠[IRR：5.10（95%CI：2.74-9.48）]、更好地工作[IRR：2.04（95%CI：1.05-3.99）]或娱乐目的[IRR：1.85（95%CI：1.04-3.32）]；未经医疗咨询就延长镇静剂治疗过程的意愿[IRR：2.45（95%CI：1.46-4.13）]；同意储存镇静剂以备将来可能需要[IRR：5.07（95%CI：2.73-9.40）]；以及不信任医生对镇静剂处方的决定[IRR：1.92（95%CI：1.12-3.30）]。知识水平与镇静剂滥用有一定的关联。
个人对镇静剂的态度与这些药物的滥用行为密切相关。教育干预性研究可以帮助降低镇静剂滥用的发生率。
