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简短报告:一项基于人群的关于新冠疫情对儿童和青年苯二氮䓬类药物使用影响的研究。

Brief Report: A population-based study of the impact of the COVID-19 pandemic on benzodiazepine use among children and young adults.

作者信息

Antoniou Tony, Pajer Kathleen, Gardner William, Penner Melanie, Lunsky Yona, McCormack Daniel, Tadrous Mina, Mamdani Muhammad, Gozdyra Peter, Juurlink David N, Gomes Tara

机构信息

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.

ICES, Toronto, ON, Canada.

出版信息

Eur Child Adolesc Psychiatry. 2025 Feb;34(2):791-794. doi: 10.1007/s00787-024-02531-6. Epub 2024 Aug 7.

Abstract

The COVID-19 pandemic was associated with increases in the prevalence of depression and anxiety among children and young adults. We studied whether the pandemic was associated with changes in prescription benzodiazepine use. We conducted a population-based study of benzodiazepine dispensing to children and young adults ≤ 24 years old between January 1, 2013, and June 30, 2022. We used structural break analyses to identify the pandemic month(s) when changes in prescription benzodiazepine dispensing occurred, and interrupted time series models to quantify changes in dispensing following the structural break and compare observed and expected benzodiazepine use. A structural break occurs where there is a sudden change in the trend of a time series. We observed an immediate decline in benzodiazepine dispensing of 23.6 per 100,000 (95% confidence interval [CI]: -33.6 to -21.2) associated with a structural break in April 2020, followed by a monthly decrease in the trend of 0.3 per 100,000 (95% CI: -0.74 to 0.14). Lower than expected benzodiazepine dispensing rates were observed each month of the pandemic from April 2020 onward, with relative percent differences ranging from - 7.4% (95% CI: -10.1% to - 4.7%) to -20.9% (95% CI: -23.2% to -18.6%). Results were generally similar in analyses stratified by sex, age, neighbourhood income quintile, and urban versus rural residence. Further research is required to understand the clinical implications of these findings and whether these trends were sustained with further follow-up.

摘要

新冠疫情与儿童和青年中抑郁症和焦虑症患病率的上升有关。我们研究了该疫情是否与处方苯二氮䓬类药物使用的变化有关。我们对2013年1月1日至2022年6月30日期间向24岁及以下儿童和青年发放苯二氮䓬类药物的情况进行了一项基于人群的研究。我们使用结构断点分析来确定处方苯二氮䓬类药物发放发生变化的疫情月份,并使用中断时间序列模型来量化结构断点后发放情况的变化,并比较观察到的和预期的苯二氮䓬类药物使用情况。结构断点发生在时间序列趋势突然变化的地方。我们观察到,与2020年4月的结构断点相关,苯二氮䓬类药物的发放立即下降,每10万人中减少23.6例(95%置信区间[CI]:-33.6至-21.2),随后每月趋势下降0.3例(95%CI:-0.74至0.14)。从2020年4月起,在疫情的每个月都观察到苯二氮䓬类药物发放率低于预期,相对百分比差异在-7.4%(95%CI:-10.1%至-4.7%)至-20.9%(95%CI:-23.2%至-18.6%)之间。按性别、年龄、邻里收入五分位数以及城市与农村居住情况分层的分析结果总体相似。需要进一步研究以了解这些发现的临床意义,以及这些趋势在进一步随访中是否持续。

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