A1 Refereed original research article in a scientific journal
Trends in the long-term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014
Authors: Kurko T, Saastamoinen LK, Tuulio-Henriksson A, Taiminen T, Tiihonen J, Airaksinen M, Hietala J
Publisher: WILEY
Publication year: 2018
Journal:: Pharmacoepidemiology and Drug Safety
Journal name in source: PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
Journal acronym: PHARMACOEPIDEM DR S
Volume: 27
Issue: 6
First page : 674
Last page: 682
Number of pages: 9
ISSN: 1053-8569
DOI: https://doi.org/10.1002/pds.4551
Abstract
PurposeLong-term benzodiazepine (BZD) treatment continues to be a debated topic. Because individual BZDs have different clinical profiles, we assessed the nationwide trends of long-term BZD use at active substance level during years 2006 to 2014.MethodsThis study covered all reimbursed BZD purchases (n=408572-521823 annually) for adults recorded in the Finnish Prescription Register. We assessed long-term use (annual cumulative purchase of 180 defined daily doses) in general, and at active substance level with the most commonly used BZD anxiolytics (oxazepam, diazepam, alprazolam, and clonazepam for nonepilepsy indications) and hypnotics (zopiclone, zolpidem, and temazepam) included. The persistence rates for each substance were assessed separately.ResultsThe prevalence of long-term BZD use among Finnish adults declined significantly from 5.3% to 3.6%, during years 2006 to 2014. Despite this decline, there was a significant increase in the long-term use of clonazepam for nonepilepsy indications and zolpidem (28.0% and 17.5%, respectively). Long-term use was common in the aged population, as well as among the users of hypnotics or clonazepam. Persistent use of 9 consecutive calendar years varied between 7.5% for incident alprazolam users and 21.0% for incident clonazepam users.ConclusionsWe found a declining trend in long-term BZD use, but the decline was not uniform between the substancesthe long-term use of clonazepam and zolpidem even increased. Follow-up research is needed to assess whether the decline in BZD use is accompanied by an increased use of other types of anxiolytic or hypnotic drugs or other forms of treatment.
PurposeLong-term benzodiazepine (BZD) treatment continues to be a debated topic. Because individual BZDs have different clinical profiles, we assessed the nationwide trends of long-term BZD use at active substance level during years 2006 to 2014.MethodsThis study covered all reimbursed BZD purchases (n=408572-521823 annually) for adults recorded in the Finnish Prescription Register. We assessed long-term use (annual cumulative purchase of 180 defined daily doses) in general, and at active substance level with the most commonly used BZD anxiolytics (oxazepam, diazepam, alprazolam, and clonazepam for nonepilepsy indications) and hypnotics (zopiclone, zolpidem, and temazepam) included. The persistence rates for each substance were assessed separately.ResultsThe prevalence of long-term BZD use among Finnish adults declined significantly from 5.3% to 3.6%, during years 2006 to 2014. Despite this decline, there was a significant increase in the long-term use of clonazepam for nonepilepsy indications and zolpidem (28.0% and 17.5%, respectively). Long-term use was common in the aged population, as well as among the users of hypnotics or clonazepam. Persistent use of 9 consecutive calendar years varied between 7.5% for incident alprazolam users and 21.0% for incident clonazepam users.ConclusionsWe found a declining trend in long-term BZD use, but the decline was not uniform between the substancesthe long-term use of clonazepam and zolpidem even increased. Follow-up research is needed to assess whether the decline in BZD use is accompanied by an increased use of other types of anxiolytic or hypnotic drugs or other forms of treatment.
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