Prescription of benzodiazepines and antidepressants to outpatients attending a Japanese university hospital.
Prescription of benzodiazepines and antidepressants to outpatients attending a Japanese university hospital.
复制标题
为日本大学医院的门诊患者开出苯二氮卓类药物和抗抑郁药。
DOI：
10.5414/cpp45030
复制
发表时间：
2007
影响因子：
0.8
通讯作者：
E. Yano
中科院分区：
文献类型：
--
作者：
M. Nakao;T. Takeuchi;E. Yano
目的
从临床和经济角度来看，过量使用苯二氮卓类药物是一个公共卫生问题。虽然日本的苯二氮卓类处方药比其他任何国家都多，但没有医院报告记录了这一现象。因此，本研究比较了日本一家医院1年内苯二氮卓类药物与选择性5-羟色胺再摄取抑制剂（SSRI）、5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRI）和其他抗抑郁药的处方频率。
材料
使用一家私立大学附属日本三级保健医院的门诊患者病历电子数据库（每年约600，000次门诊就诊），评估苯二氮卓类药物的年度处方与抗抑郁药的年度处方。
方法
对科室组进行单独分析（即内科、外科、神经病学、精神病学和其他）。计算各科室组抗焦虑苯二氮卓类药物处方数与SSRI、SNRI处方数的比值，作为苯二氮卓类药物与抗抑郁药处方比较的指标之一。
结果
在644，444张医院处方中，6.1%为抗焦虑苯二氮卓类药物，5.8%为催眠苯二氮卓类药物。关于抗抑郁药，1.6%的处方是SSRIs/SNRIs，0.8%是三环类抗抑郁药，1.5%是其他抗抑郁药。在苯二氮卓类药物处方中，26.8%由内科组开具。抗焦虑苯二氮卓类药物处方数与SSRI和SNRI处方数的比值在内科最高（比值= 13.0），其次是外科（7.6）、神经科（4.8）和精神科（2.5）。以精神科为参照，在控制了患者年龄和性别的影响后，在多元Logistic回归分析中，在其余四个科室组中，开抗焦虑药苯二氮卓类药物而不是SSRI或SNRI的趋势具有统计学显著性。
结论
在日本医院，苯二氮卓类药物的处方远比SSRIs和SNRIs等抗抑郁药的处方更常见，尤其是在内科。需要在日本医院以及其他国家的医院进行多机构研究来解决这个问题。
OBJECTIVE
Excessive benzodiazepine use is a public health concern from clinical and economical perspectives. Although more benzodiazepines are prescribed in Japan than in any other country, no hospital-based report has documented this phenomenon. Therefore, this study compared the prescription frequency of benzodiazepines with that of selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors (SNRIs), and other antidepressants in a single Japanese hospital over 1 year.
MATERIAL
The annual prescription of benzodiazepines was assessed with that of antidepressants using an electronic database of medical records for outpatients at a Japanese tertiary care hospital affiliated with a private university with approximately 600,000 outpatient visits annually.
METHOD
Groups of departments were analyzed separately (i.e. internal medicine, surgery, neurology, psychiatry, and others). The ratio of the number of prescriptions of anxiolytic benzodiazepines to that of SSRI and SNRI was calculated among the department groups and used as one of indicators comparing the prescriptions of benzodiazepines with those of antidepressants.
RESULTS
Of 644,444 hospital prescriptions, 6.1% were for anxiolytic benzodiazepines, and 5.8% were for hypnotic benzodiazepines. Regarding antidepressants, 1.6% of prescriptions were for SSRIs/SNRIs, 0.8% were for tricyclic antidepressants, and 1.5% were for other antidepressants. Of the benzodiazepine prescriptions, 26.8% were written by the internal medicine group. The ratio of the number of prescriptions for anxiolytic benzodiazepines to that for SSRI and SNRI was highest in the department of internal medicine (ratio = 13.0), followed by surgery (7.6), neurology (4.8), and psychiatry (2.5). With the department of psychiatry as the reference, the tendency to prescribe an anxiolytic benzodiazepine rather than an SSRI or SNRI was statistically significant in the remaining four department groups, after controlling for the effects of patient age and sex in a multiple logistic regression analysis.
CONCLUSIONS
Benzodiazepine prescriptions in the Japanese hospital were far more common than prescriptions for antidepressants such as SSRIs and SNRIs, especially in internal medicine. Multi-institutional studies are needed to address this issue in Japanese hospitals, as well as in hospitals in other countries.