2012 年至 2019 年全美急诊科苯二氮卓类药物出院处方:全国分析。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-07-01 Epub Date: 2024-05-22 DOI:10.1097/ADM.0000000000001310
Christine Ramdin, George Mina, Lewis Nelson, Maryann Mazer-Amirshahi
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引用次数: 0

摘要

目标:苯二氮卓类药物是常见的滥用药物,经常与用药过量致死有关。数据显示,苯二氮卓类药物的处方与滥用增加有关。我们试图确定全国急诊科(ED)开具苯二氮卓类药物处方的趋势:这是一项对 2012 年至 2019 年全国医院非住院医疗护理调查的回顾性研究。我们的主要结果是评估出院时开具苯二氮卓类药物的急诊就诊趋势。其次,我们确定了常用的苯二氮卓类药物处方,并评估了其随时间变化的趋势。我们检查了人口统计学数据,并酌情使用了描述性统计和Spearman rho或Pearson相关系数:2012 年至 2019 年间,急诊室出院时开具苯二氮卓类药物处方的就诊人次为 13,848,578 次。2012年和2019年,分别有1,407,478人次(占所有急诊室就诊人次的1.1%)和1,361,372人次(0.9%)开出了苯二氮卓类药物处方(平均值[标度],1,731,072 [287,623] [1.26%]),且无趋势(P = 0.31)。常见的苯二氮卓类药物处方为地西泮(5,980,279 人次,占所有处方的 43.2%)、阿普唑仑(3,306,549 人次,占 23.9%)和氯硝西泮(2,105,963 人次,占 15.2%),这些处方没有随时间发生变化。15%的处方用于 65 岁或以上的患者:结论:尽管有滥用增加的报道,但急诊室出院苯二氮卓类药物的处方量没有变化。令人担忧的是,阿普唑仑这种苯二氮卓类药物的滥用可能性很高,尽管急诊室的适应症有限,但却经常被开出处方,而且尽管有警告称苯二氮卓类药物对老年人群有不良影响,但还是有很大比例的就诊处方被开给了老年人。未来的研究应评估合理处方以及有针对性的干预措施在遏制不当使用方面的作用。
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Benzodiazepine Discharge Prescriptions From Emergency Departments Across the United States Between 2012 and 2019: A National Analysis.

Objectives: Benzodiazepines are commonly misused medications frequently implicated in overdose deaths. Data show that benzodiazepine prescribing is associated with increased misuse. We sought to determine national trends in benzodiazepine prescribing from the emergency department (ED).

Methods: This is a retrospective review of the National Hospital Ambulatory Medical Care Survey from 2012 to 2019. Our primary outcome was to evaluate trends in ED visits where a benzodiazepine was prescribed at discharge. Secondarily, we identified commonly prescribed benzodiazepines and assessed trends over time. We examined demographic data and used descriptive statistics and Spearman rho or Pearson correlation coefficient as applicable.

Results: Between 2012 and 2019, there were 13,848,578 visits where benzodiazepines were prescribed at ED discharge. In 2012 and 2019, there were 1,407,478 visits (1.1% of all ED visits) and 1,361,372 visits (0.9%), respectively, where benzodiazepines were prescribed (mean [SD], 1,731,072 [287,623] [1.26%]), with no trend ( P = 0.31). Common benzodiazepines prescribed were diazepam (5,980,279 visits, 43.2% of all prescriptions), alprazolam (3,306,549, 23.9%), and clonazepam (2,105,963, 15.2%), with no changes over time. Fifteen percent of prescriptions were for patients 65 years or older.

Conclusion: Despite reports of increased misuse, there was no change in ED discharge benzodiazepine prescribing. Concerningly, alprazolam, a benzodiazepine with high misuse potential, was frequently prescribed despite limited ED indications, and there was a large percentage of visits where benzodiazepines were prescribed to older adults despite warnings for adverse effects in this population. Future studies should assess rational prescribing and the role of targeted interventions to curb inappropriate use.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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