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. 2018 Jun;84(6):1354-1363.
doi: 10.1111/bcp.13570. Epub 2018 Apr 16.

Benzodiazepine and Z-drug prescribing in Ireland: analysis of national prescribing trends from 2005 to 2015

Cathal A Cadogan  1 , Cristín Ryan  2 , Caitriona Cahir  3 , Colin P Bradley  4 , Kathleen Bennett  3
Affiliations

Benzodiazepine and Z-drug prescribing in Ireland: analysis of national prescribing trends from 2005 to 2015

Cathal A Cadogan et al. Br J Clin Pharmacol. 2018 Jun.

Abstract

Aims: The aim of this study was to examine prescribing trends for benzodiazepines and Z-drugs to General Medical Services (GMS) patients in Ireland.

Methods: A repeated cross-sectional analysis of the national pharmacy claims database was conducted for GMS patients aged ≥16 years from 2005 to 2015. Prescribing rates per 1000 eligible GMS population were calculated with 95% confidence intervals (CIs). Negative binomial regression was used to determine longitudinal trends and compare prescribing rates across years, gender and age groups. Duration of supply and rates of concomitant benzodiazepine and Z-drug prescribing were determined. Age (16-44, 45-64, ≥65 years) and gender trends were investigated.

Results: Benzodiazepine prescribing rates decreased significantly from 225.92/1000 population (95% CI 224.94-226.89) in 2005 to 166.07/1000 population (95% CI 165.38-166.75) in 2015 (P < 0.0001). Z-drug prescribing rates increased significantly from 95.36/1000 population (95% CI 94.73-96.00) in 2005 to 109.11/1000 population (95% CI 108.56-109.67) in 2015 (P = 0.048). Approximately one-third of individuals dispensed either benzodiazepines or Z-drugs were receiving long-term prescriptions (>90 days). The proportion of those receiving >1 benzodiazepine and/or Z-drug concomitantly increased from 11.9% in 2005 to 15.3% in 2015. Benzodiazepine and Z-drug prescribing rates were highest for older women (≥65 years) throughout the study period.

Conclusions: Benzodiazepine prescribing to the GMS population in Ireland decreased significantly from 2005 to 2015, and was coupled with significant increases in Z-drug prescribing. The study shows that benzodiazepine and Z-drug prescribing is common in this population, with high proportions of individuals receiving long-term prescriptions. Targeted interventions are needed to reduce potentially inappropriate long-term prescribing and use of these medications in Ireland.

Keywords: Z-drugs; benzodiazepines; potentially inappropriate prescribing; primary care.

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Figures

Figure 1
Figure 1
Prescribing rates for (A) benzodiazepines and Z‐drugs, (B) short‐acting and long‐acting benzodiazepines [BZDs] and (C) hypnotics and anxiolytics issued to GMS‐eligible individuals aged ≥16 years from 2005 to 2015
Figure 2
Figure 2
Prescribing rates for individual (A) benzodiazepine anxiolytics and anticonvulsants and (B) benzodiazepine and Z‐drug hypnotics issued to GMS‐eligible individuals aged ≥16 years from 2005 to 2015
Figure 3
Figure 3
Proportion of GMS‐eligible individuals aged ≥16 years receiving duplicate prescriptions involving combinations of benzodiazepines and/or Z‐drugs from 2005 to 2015
Figure 4
Figure 4
Incidence rates for new benzodiazepine (BZD) and Z‐drug prescriptions issued to GMS‐eligible patients aged ≥16 years from 2006 to 2015 according to gender and age
Figure 5
Figure 5
Duration of consecutive benzodiazepine and Z‐drug use for GMS‐eligible individuals aged ≥16 years during study period
See this image and copyright information in PMC

References

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