McNutt L A, Coles F B, McAuliffe T, Baird S, Morse D L, Strogatz D S, Baron R C, Eadie J L
Bureau of Communicable Disease Control, New York State Department of Health, Albany 12237, USA.
J Clin Epidemiol. 1994 Jun;47(6):613-25. doi: 10.1016/0895-4356(94)90209-7.
On 1 January 1989, in an effort to reduce diversion of benzodiazepines for illicit use and reduce inappropriate prescribing, a regulation was implemented requiring the reporting of all benzodiazepine prescriptions to the New York State Department of Health. To assess the impact of the regulation on prescribing practices to the elderly, we followed the number of benzodiazepines and other central nervous system medications prescribed to a cohort of participants in an elderly pharmaceutical insurance program. Benzodiazepines were prescribed for 4652 (22%) of the 20,944 patients studied. By the last quarter of 1989, benzodiazepines were prescribed for 3120 (15%) patients, a decrease of 33%. The number of prescriptions of benzodiazepines decreased by 5010 (45%), from 11,123 to 6113. Decreases in the number of prescriptions were similar across benzodiazepine brands (range 40-56%). Statistically significant (p < 0.05) decreases were seen in all sex, age, race and marital status groups. Increases in number (and percent increases) of prescriptions for miscellaneous anxiolytics (i.e. hydroxyzine (399, 69%), meprobamate (299, 149%), buspirone (263, 111%), chloral hydrate (138, 265%), antidepressants (658, 19%), barbiturates (150, 29%), and tranquilizers (198, 19%), some of which may be more toxic or less effective, were noted. New York State's reporting regulation was effective in reducing both the number of patients being prescribed benzodiazepines and the number of prescriptions given to those who remain on benzodiazepines in the elderly population studies.
1989年1月1日，为减少苯二氮䓬类药物被转用于非法用途以及减少不当处方，一项规定开始实施，要求向纽约州卫生部报告所有苯二氮䓬类药物的处方。为评估该规定对老年人处方行为的影响，我们跟踪了老年药物保险项目中一组参与者所开具的苯二氮䓬类药物及其他中枢神经系统药物的数量。在研究的20944名患者中，有4652名（22%）患者开具了苯二氮䓬类药物。到1989年最后一个季度，开具苯二氮䓬类药物的患者有3120名（15%），减少了33%。苯二氮䓬类药物的处方数量减少了5010份（45%），从11123份降至6113份。不同苯二氮䓬类品牌的处方数量降幅相似（范围为40% - 56%）。在所有性别、年龄、种族和婚姻状况组中，处方数量均出现了具有统计学意义（p < 0.05）的下降。我们注意到，其他各类抗焦虑药（即羟嗪（399份，增长69%）、甲丙氨酯（299份，增长149%）、丁螺环酮（263份，增长111%）、水合氯醛（138份，增长265%））、抗抑郁药（658份，增长19%）、巴比妥类药物（150份，增长29%）以及镇静剂（198份，增长19%）的处方数量（及增长百分比）有所增加，其中一些药物可能毒性更大或效果更差。在老年人群研究中，纽约州的报告规定在减少开具苯二氮䓬类药物的患者数量以及给仍在服用苯二氮䓬类药物患者的处方数量方面均有成效。
