Anxiety and mood (대한불안의학회지)

Korean Academy of Anxiety Disorders (대한불안의학회)
권호 표지

Prescription Patterns of Benzodiazepine for Outpatients in a Psychiatric Department in Korea

일 종합병원 정신건강의학과 외래환자에서 벤조디아제핀 사용

  • Lee, Jai Young (Department of Psychiatry, School of Medicine, Kyung Hee University) ;
  • Kang, Won Sub (Department of Psychiatry, School of Medicine, Kyung Hee University) ;
  • Kim, Jong Woo (Department of Psychiatry, School of Medicine, Kyung Hee University) ;
  • Kim, Young Jong (Department of Psychiatry, School of Medicine, Kyung Hee University)
  • 이재영 (경희대학교 의과대학 정신건강의학교실) ;
  • 강원섭 (경희대학교 의과대학 정신건강의학교실) ;
  • 김종우 (경희대학교 의과대학 정신건강의학교실) ;
  • 김영종 (경희대학교 의과대학 정신건강의학교실)
  • Received : 2015.09.07
  • Accepted : 2015.10.19
  • Published : 2015.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : This study examined benzodiazepine prescription patterns of outpatients visiting the psychiatry department in a single general hospital in Korea. Methods : A retrospective descriptive analysis of benzodiazepine prescriptions was performed on a database from 2014 in a general hospital in Korea. We analyzed the following factors of adult outpatients: demographic factors such as sex and age, amount of benzodiazepine prescribed, treatment duration, and diagnosis based on the ICD-10. Results : In 2014, benzodiazepines were prescribed to 46.4% of the outpatients. Percentage of benzodiazepine prescription increased with age and was highest in the age group 40-59 years. Prescription was more prevalent in women and the prescription percentage increased by treatment duration. Patients with the F4 diagnosis (neurotic, stress-related and somatoform disorders) were the most highly prescribed group. For all diagnosis groups, prescription was more prevalent in females or similar for both sexes except for patients with F5 diagnosis (behavioral syndromes associated with physiological disturbances and physical factors), with males being more predominant. Conclusion : Despite the concern regarding the rate of benzodiazepine prescription and administration to geriatric patients, long-term prescription and usage among older patients is still prevalent.

Keywords

References

  1. Sonnenberg CM, Bierman EJM, Deeg DJH, Comijs HC, van Tilburg W, Beekman AT. Ten-year trends in benzodiazepine use in the Dutch population. Soc Psychiatry Psychiatr Epidemiol 2012;47:293-301. https://doi.org/10.1007/s00127-011-0344-1
  2. Luijendijk HJ, Tiemeler H, Hofman A, Heeringa J, Stricker BH. Determinants of chronic benzodiazepine use in the elderly: a longitudinal study. Br J Clin Pharmacol 2008;65:593-599 https://doi.org/10.1111/j.1365-2125.2007.03060.x
  3. McLeod PJ, Huang AR, Tamblyn RM, Gayton DC. Defining inappropriate practices in prescribing for elderly people a national consensus panel. CMAJ 1997;156:385-391.
  4. Gray SL, LaCroix AZ, Hanlon JT, Penninx BWJH, Blough DK, Leveille SG, et al. Benzodiazepine use and physical disability in community-dwelling older adults. J Am Geriatr Soc 2006;54:224-230 https://doi.org/10.1111/j.1532-5415.2005.00571.x
  5. Madhusoodanan S, Bogunovic OJ. Safety of benzodiazepines in the geriatric population. Expert Opin Drug Saf 2004;3:485-493. https://doi.org/10.1517/14740338.3.5.485
  6. Cook JM, Biyanova T, Masci C, Coyne JC. Patient perspectives on long-term anxiolytic benzodiazepine use and discontinuation: a qualitative study. J Gen Intern Med 2007;22:1094-1100 https://doi.org/10.1007/s11606-007-0205-5
  7. Hogan DB, Maxwell CJ, Fung TS, Ebly EM. Prevalence and potential consequences of benzodiazepine use in senior citizens: results from the Canadian Study of Health and Aging. Can J Clin Pharmacol 2003;10:72-77
  8. Cunningham CM, Hanley GE, Morgan S. Patterns in the use of benzodiazepines in British Columbia: examining the impact of increasing research and guideline cautions against long-term use. Health Policy 2010;97: 122-129. https://doi.org/10.1016/j.healthpol.2010.03.008
  9. Olfson M, King M, Schoenbaum. Benzodiazepine use in the United States. JAMA Psychiatry 2015;72:136-142. https://doi.org/10.1001/jamapsychiatry.2014.1763
  10. National Evidence-based Healthcare Collaborating Agency. Prescription pattern and safety of benzodiazepines;2012.
  11. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders, Clinical Descriptions and Diagnostic Guidelines. an edition in Korean. Seoul: Il Cho Kak;1992.
  12. Hogan DB, Maxwell CJ, Fung TS, Ebly EM. Canadian Study of Health and Aging. Prevalenceand potential consequences of benzodiazepine usein senior citizens: results from the Canadian Studyof Health and Aging. Can J Clin Pharmacol 2003;10:72-77.
  13. Petitjean S, Ladewig D, Meier CR, Amrein R, Wiesbeck GA. Benzodiazepine prescribing to the Swiss adult population: results from a national survey of community pharmacies. Int Clin Psychopharmacol 2007;22:292-298. https://doi.org/10.1097/YIC.0b013e328105e0f2
  14. Simon GE, Ludman EJ. Outcome of new benzodiazepine prescriptions to older adults in primary care. Gen Hosp Psychiatry 2006;28:374-378. https://doi.org/10.1016/j.genhosppsych.2006.05.008
  15. Manthey L, Giltay EJ, van Veen T, Neven AK, Zitman FG, Perminx BW. Determinants of initiated and continued benzodiazepine use in the Netherlands study of depression and anxiety. J Clin Psychopharmacol 2011;31:774-779. https://doi.org/10.1097/JCP.0b013e3182362484
  16. Ancoli-Israel S. Sleep and its disorders in aging populations. Sleep Med 2009;10:S7-S11.
  17. Wolitzky-Taylor KB, Castriotta N, Lenze EJ, Stanley MA, Craske MG. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety 2010;27:190-211. https://doi.org/10.1002/da.20653
  18. Manthey L, Giltay EJ, van Veen T, Neven AK, Zitman FG, Penninx BW. Determinants of initiated and continued benzodiazepine use in the Netherlands study of depression and anxiety. J Clin Psychopharmacol 2011;31:774-779. https://doi.org/10.1097/JCP.0b013e3182362484
  19. Lagnaoui R, Depont F, Fourrier A, Abouelfath A, Begaud B, Verdoux H, et al. Patterns and correlates of benzodiazepine use in the French-general population. Eur J Clin Pharmacol 2004;60:523-529 https://doi.org/10.1007/s00228-004-0808-2
  20. van Hulten R, Teeuw KB, Bakker A, Leufkens HG. Initial 3-month usage characteristics predict longterm use of benzodiazepines: an 8-year follow-up. Eur J Clin Pharmacol 2003;58:689-694. https://doi.org/10.1007/s00228-002-0548-0
  21. Van der Heyden JHA, Gisle L, Hesse E, Demarest S, Drieskens S, Tafforeau J. Gender differences in the use of anxiolytics and antidepressants: a population based study. Pharmacoepidemiol Drug Saf 2009;18:1101-1110. https://doi.org/10.1002/pds.1827
  22. Mendelson WB. Clinical distinctions between long-acting and short-acting benzodiazepines. J Clin Psychiatry 1992;53:4-7.
  23. Finkle WD, Der JS, Greenland S, Adams JL, Ridgeway G, Blaschke T, et al. Risk of fractures requiring hospitalization after an initial prescription for zolpidem, alprazolam, lorazepam, or diazepam in older adults. J Am Geriatr Soc 2011;59:1883-1890. https://doi.org/10.1111/j.1532-5415.2011.03591.x
  24. Lai MM, Lin CC, Lin Ce, Liu CS, Li TC, Kao CH. Long-term use of zolpidem increases the risk of major injury: a population-based cohort study. Mayo Clin Proc 2014;89:589-594. https://doi.org/10.1016/j.mayocp.2014.01.021
  25. Cook JM, Biyanova T, Masci C, Coyne JC. Older patient perspectives on long-term anxiolytic benzodiazepine use and discontinuation: a qualitative study. J Gen Intern Med 2007;22:1094-1100. https://doi.org/10.1007/s11606-007-0205-5
  26. Gould RL, Coulson MC, Patel N, Highton-Williamson E, Howard RJ. Interventions for reducing benzodiazepine use in older people: meta-analysis ofrandomised controlled trials. Br J Psychiatry 2014;204:98-107 https://doi.org/10.1192/bjp.bp.113.126003
  27. Mugunthan K, McGuire T, Glasziou P. Minimal interventions to decrease long-term use of benzodiazepines in primary care: a systematic review and meta-analysis. Br J Gen Pract 2011;61:e573-e578. https://doi.org/10.3399/bjgp11X593857