Centre for Academic Mental Health, University of Bristol, Bristol Medical School, Bristol.
School of Medicine, Keele University, Staffordshire.
Br J Gen Pract. 2024 Oct 31;74(748):e742-e748. doi: 10.3399/BJGP.2024.0211. Print 2024 Nov.
Incident benzodiazepine prescriptions in primary care for anxiety decreased between 2003 and 2018. However, from 2008, incident prescribing of benzodiazepines for anxiety increased among those aged 18-34 years. There are increasing concerns around prescribing of benzodiazepines. Further, although guidelines state benzodiazepines should only be prescribed short term, in 2017, 44% of incident prescriptions were prescribed for longer than the recommended duration of 2-4 weeks.
To understand when and why GPs prescribe benzodiazepines for anxiety in young adults.
A qualitative study was undertaken using in-depth interviews with 17 GPs from 10 general practices in South West England.
Interviews were conducted by telephone or videocall. A topic guide was used to ensure consistency across interviews. Interviews were audio-recorded, transcribed verbatim, and data analysed using reflexive thematic analysis.
GPs described caution in prescribing benzodiazepines for anxiety in young adults, but thought they had an important role in acute situations. GPs described caution in prescribing duration, but some thought longer-term prescriptions could be appropriate. In light of these views, some GPs questioned whether primary care needs to revisit how clinicians are using benzodiazepines. GPs perceived that some young adults requested benzodiazepines and suggested this might be because they wanted quick symptom relief. GPs noted that refusing to prescribe felt uncomfortable and that the number of young adults presenting to general practice, already dependent on benzodiazepines, had increased.
Patient-driven factors for prescribing benzodiazepines suggest there are current unmet treatment needs among young adults with anxiety. Given increases in prescribing in this age group, it may be timely to revisit the role of benzodiazepines in the management of people with anxiety in primary care.
2003 年至 2018 年期间，初级保健中治疗焦虑症的苯二氮䓬类药物的偶发处方有所减少。然而，自 2008 年以来，18-34 岁人群中治疗焦虑症的苯二氮䓬类药物偶发处方有所增加。人们越来越关注苯二氮䓬类药物的处方问题。此外，尽管指南指出苯二氮䓬类药物应短期使用，但 2017 年，44%的偶发性处方的使用时间超过了 2-4 周的推荐时长。
了解全科医生为何在年轻人中开具苯二氮䓬类药物治疗焦虑症。
本研究采用定性研究方法，对来自英格兰西南部 10 家全科医疗实践的 17 名全科医生进行了深入访谈。
通过电话或视频通话进行访谈。使用主题指南确保访谈内容的一致性。访谈内容被录音、逐字转录，并使用反思性主题分析进行数据分析。
全科医生表示在为年轻人开具苯二氮䓬类药物治疗焦虑症时持谨慎态度，但认为它们在急性情况下具有重要作用。全科医生表示在开具药物持续时间方面持谨慎态度，但一些人认为长期处方可能是合适的。鉴于这些观点，一些全科医生质疑初级保健是否需要重新审视临床医生使用苯二氮䓬类药物的方式。全科医生认为一些年轻人要求开苯二氮䓬类药物，这可能是因为他们希望快速缓解症状。全科医生注意到拒绝开处方会感到不舒服，而且已经依赖苯二氮䓬类药物的年轻成年人就诊数量有所增加。
开处方的患者驱动因素表明，焦虑症的年轻成年人存在当前未满足的治疗需求。鉴于该年龄段的处方量增加，现在可能需要重新审视苯二氮䓬类药物在初级保健中治疗焦虑症患者的作用。
