Benzodiazepine Use in the United States
Benzodiazepine Use in the United States
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DOI：
10.1001/jamapsychiatry.2014.1763
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发表时间：
2015-02-01
期刊：
影响因子：
25.8
通讯作者：
Schoenbaum, Michael
中科院分区：
文献类型：
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作者：
Olfson, Mark;King, Marissa;Schoenbaum, Michael
重要性虽然关注的是苯二氮卓类药物的使用率，特别是老年人的长期使用，但关于美国苯二氮卓类药物使用模式的信息很少。与参与者使用2008年LifeLink LRx纵向处方数据库对苯二氮卓类药物处方进行回顾性描述性分析（IMS Health Inc），其中包括美国所有零售药店的约60%。分母进行调整，以概括美国人口的估计。主要结果和措施的百分比，成人填写1个或多个苯二氮卓类处方在研究年按性别和年龄组（18-35岁、36-50岁、51-64岁和65-80岁）和接受苯二氮卓类药物的个体中，长期（>= 120天）苯二氮卓类药物使用、长效苯二氮卓类药物处方和精神科医生开具的苯二氮卓类药物处方的相应百分比。使用苯二氮卓类药物的百分比随年龄增长而增加，从2.6%（18-35岁）增加到5.4%（36-50岁），从7.4%（51-64岁）增加到8.7%（65-80岁）。苯二氮卓类药物的使用在女性中几乎是男性的两倍。长期使用苯二氮卓类药物的比例随着年龄的增长而增加，从14.7%（18-35岁）增加到31.4%（65-80岁），而从精神科医生处接受苯二氮卓类药物处方的比例随着年龄的增长而下降，从15.0%（18-35岁）下降到5.7%（65-80岁）。在所有年龄组中，大约四分之一的人接受benzodiazepines涉及长效benzodiazepines use.CONCLUSIONS和RELEVANCE尽管有关长期benzodiazepines使用相关风险的警告，特别是在老年患者中，长期benzodiazepines使用仍然很常见，在这个年龄组。可能需要更有力的临床干预，支持明智地使用苯二氮卓类药物，以降低老年人长期使用苯二氮卓类药物的比例。
IMPORTANCE Although concern exists regarding the rate of benzodiazepine use, especially long-term use by older adults, little information is available concerning patterns of benzodiazepine use in the United States.OBJECTIVE To describe benzodiazepine prescription patterns in the United States focusing on patient age and duration of use.DESIGN, SETTING, AND PARTICIPANTS A retrospective descriptive analysis of benzodiazepine prescriptions was performed with the 2008 LifeLink LRx Longitudinal Prescription database (IMS Health Inc), which includes approximately 60% of all retail pharmacies in the United States. Denominators were adjusted to generalize estimates to the US population.MAIN OUTCOMES AND MEASURES The percentage of adults filling 1 or more benzodiazepine prescriptions during the study year by sex and age group (18-35 years, 36-50 years, 51-64 years, and 65-80 years) and among individuals receiving benzodiazepines, the corresponding percentages with long-term (>= 120 days) benzodiazepine use, prescription of a long-acting benzodiazepine, and benzodiazepine prescriptions from a psychiatrist.RESULTS In 2008, approximately 5.2% of US adults aged 18 to 80 years used benzodiazepines. The percentage who used benzodiazepines increased with age from 2.6% (18-35 years) to 5.4%(36-50 years) to 7.4%(51-64 years) to 8.7%(65-80 years). Benzodiazepine use was nearly twice as prevalent in women as men. The proportion of benzodiazepine use that was long term increased with age from 14.7%(18-35 years) to 31.4% (65-80 years), while the proportion that received a benzodiazepine prescription from a psychiatrist decreased with age from 15.0%(18-35 years) to 5.7%(65-80 years). In all age groups, roughly one-quarter of individuals receiving benzodiazepine involved long-acting benzodiazepine use.CONCLUSIONS AND RELEVANCE Despite cautions concerning risks associated with long-term benzodiazepine use, especially in older patients, long-term benzodiazepine use remains common in this age group. More vigorous clinical interventions supporting judicious benzodiazepine use may be needed to decrease rates of long-term benzodiazepine use in older adults.