Lee Kyung Jin, Wei Yue, Leung Shek-Ming, Huang Caige, Yiu Hei Hang Edmund, Deng Eunice Kehui, Castle David J, Lui Simon S Y, Wong Vincent K C, Wong Ian C K, Chan Esther W
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong SAR, China.
Lancet Reg Health West Pac. 2025 Jun 10;59:101591. doi: 10.1016/j.lanwpc.2025.101591. eCollection 2025 Jun.
Concerns are growing about the long-term use of benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs) due to adverse effects such as drug tolerance, dependence, cognitive dysfunction, and falls, particularly in the elderly. This study aims to understand thorough prescribing patterns of BZDs and Z-drugs across age groups in clinical settings of Hong Kong, especially the long-term prescriptions.
Using territory-wide electronic health record data from Hong Kong (2014-2023), we analysed the prevalence, incidence, and duration of BZD and Z-drug prescriptions in adults. Long-term use was defined as prescriptions exceeding 90 days. Joinpoint regression models assessed trend changes, focusing on four age groups: 18-25, 26-49, 50-64, and ≥65. Psychiatric diagnoses within 180 days before and after treatment initiation were also evaluated.
Patients with BZD and Z-drug prescribing increased from 2014 to 2023, with an average annual percentage change (AAPC) of 3.44 [95% CI: 3.26-3.61] in prevalence and 1.51 [0.64-2.45] in incidence. Trends varied by age: the sharpest increases were observed in young adults aged 18-25 (prevalence AAPC: 9.43 [8.36-10.51]; incidence AAPC: 7.56 [6.19-8.89]), whereas the incidence in those aged ≥65 declined after 2019, although it remained the highest. Prevalence of patients with long-term prescribing rose consistently, particularly in young adults (BZD AAPC: 13.43 [11.98-14.62]; Z-drug AAPC: 12.88 [7.85-18.24]). Depression and dementia were the most common psychiatric diagnoses within 180 days before and after treatment initiation.
These findings highlight the need to review long-term prescribing practices and establish clear guidelines for safe BZD and Z-drug use, especially among young adults.
No funding has been provided for this research.
由于存在药物耐受性、依赖性、认知功能障碍和跌倒等不良反应，尤其是在老年人中，人们对苯二氮䓬类药物（BZD）和非苯二氮䓬类药物（Z类药物）的长期使用愈发担忧。本研究旨在深入了解香港临床环境中各年龄组BZD和Z类药物的处方模式，特别是长期处方情况。
利用香港全地区的电子健康记录数据（2014 - 2023年），我们分析了成人中BZD和Z类药物处方的患病率、发病率和持续时间。长期使用定义为处方超过90天。连接点回归模型评估趋势变化，重点关注四个年龄组：18 - 25岁、26 - 49岁、50 - 64岁和≥65岁。还评估了治疗开始前后180天内的精神科诊断情况。
2014年至2023年，开具BZD和Z类药物处方的患者有所增加，患病率的平均年百分比变化（AAPC）为3.44 [95%置信区间：3.26 - 3.61]，发病率的AAPC为1.51 [0.64 - 2.45]。各年龄组趋势不同：18 - 25岁的年轻人中增幅最为显著（患病率AAPC：9.43 [8.36 - 10.51]；发病率AAPC：7.56 [6.19 - 8.89]），而≥65岁人群的发病率在2019年后有所下降，尽管仍为最高。长期处方患者的患病率持续上升，尤其是在年轻人中（BZD的AAPC：13.43 [11.98 - 14.62]；Z类药物的AAPC：12.88 [7.85 - 18.24]）。抑郁症和痴呆症是治疗开始前后180天内最常见的精神科诊断。
这些发现凸显了审查长期处方做法并制定安全使用BZD和Z类药物明确指南的必要性，尤其是在年轻人中。
本研究未获得资金支持。
