Discipline of General Practice, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Australia.
Adelaide Institute for Sleep Health and Flinders Health and Medical Research Institute, Sleep Health, Flinders University, Australia.
Drug Alcohol Rev. 2023 Feb;42(2):427-438. doi: 10.1111/dar.13561. Epub 2022 Oct 10.
We aimed to explore trends and sociodemographic patterns in benzodiazepine (BZD) (by half-life) and Z-drugs prescribing in Australian general practice.
This open cohort study used de-identified electronic health records of 1.4 million patients (50,812,413 consultations) from 402 Australian practices (MedicineInsight 2011-2018). Annual prescribing frequency and changes over time were estimated according to sex, age, socioeconomic position and rurality.
Between 2011 and 2018, the prescribing of very short-acting BZD increased from 0.10 to 0.29 per 1000 consultations (average annual change +17.2% [95% CI 9.6; 25.3]), while it declined for short-intermediate (from 38.5 to 26.6 per 1000 consultations; annual change -5.1% [95% CI -5.6; -4.5]), long-acting BZD (from 24.1 to 21.6 per 1000 consultation; annual change -1.5% [95% CI -2.2; -0.8]) and Z-drugs (from 4.6 to 4.0 per 1000 consultations; annual change -1.9% [95% CI -3.0; -0.7]). Short-intermediate-acting BZD prescribing was three times more frequent among women aged 65+ years than younger women, and long-acting BZD three-to-four times more likely among younger than older men. Z-drugs prescribing was higher among women aged 45-64 years than younger or older females. Short-intermediate- and long-acting BZD were more likely prescribed for patients from more disadvantaged areas, and Z-drugs in more advantaged areas. There were no disparities by rurality.
Although most BZD and Z-drugs prescriptions declined over time, short-intermediate BZD prescriptions remained higher among older women and long-acting BZD more frequent among younger men, especially for those living in more disadvantaged areas. Targeted interventions could reduce the prescribing of BZD and Z-drugs in these groups.
我们旨在探索澳大利亚全科医学中苯二氮䓬类药物（根据半衰期）和 Z 类药物的开处方趋势和社会人口统计学模式。
本开放队列研究使用了来自 402 家澳大利亚诊所的 140 万名患者（50812413 次就诊）的去识别电子健康记录（MedicineInsight 2011-2018 年）。根据性别、年龄、社会经济地位和农村/城市情况，估算了每年的开处方频率和随时间的变化。
2011 年至 2018 年间，超短效苯二氮䓬的开处方量从每 1000 次就诊 0.10 次增加到 0.29 次（年平均增长率为 17.2% [95%CI 9.6; 25.3]），而短效-中效（从每 1000 次就诊 38.5 次减少到 26.6 次；年变化率为-5.1% [95%CI -5.6; -4.5]）、长效苯二氮䓬（从每 1000 次就诊 24.1 次减少到 21.6 次；年变化率为-1.5% [95%CI -2.2; -0.8]）和 Z 类药物（从每 1000 次就诊 4.6 次减少到 4.0 次；年变化率为-1.9% [95%CI -3.0; -0.7]）的开处方量下降。65 岁以上女性中，短效-中效苯二氮䓬的开处方频率是年轻女性的三倍，而年轻男性中长效苯二氮䓬的开处方频率是年长男性的三到四倍。45-64 岁的女性中 Z 类药物的开处方频率高于年轻或年长的女性。短效-中效和长效苯二氮䓬更可能开给来自较不利地区的患者，而 Z 类药物更可能开给较有利地区的患者。农村/城市地区之间没有差异。
尽管大多数苯二氮䓬类药物和 Z 类药物的处方量随时间下降，但超短效苯二氮䓬类药物的处方量仍在老年女性中较高，而长效苯二氮䓬类药物在年轻男性中更常见，尤其是在社会经济地位较低的地区。有针对性的干预措施可以减少这些人群中苯二氮䓬类药物和 Z 类药物的处方。
