| Objective: To understand the current and long-term use of benzodiazepines(BZDs)in psychiatric outpatients of Jining Psychiatric Prevention and Treatment Hospital(later referred to as the survey unit),and understand its influencing factors from general demographic information,disease-related information and combined medication.It is hoped that this can bring some beneficial enlightenment to the clinical rational use of benzodiazepines and provide relevant reference for the formulation of relevant policies.Methods: Patients in the psychiatric outpatient department of Jining Psychiatric Prevention Hospital were studied.The survey sample was selected by stratified cluster sampling.First of all,a sample of psychiatric outpatients from January 1,2018 to December 31,2018 was taken as a sample.The year was divided into four layers,one for every three months,each layer contained about 90 days.Then,the method of random digital table was used to take the outpatient clinic patients in each layer for 3consecutive days as the survey sample.On the same day outpatient psychiatric patients from the end of the computer to fill out a self-compiled benzodiazepine drug use questionnaire survey,and statistical analysis.If there are patients with repeated statistics during thesurvey,the previous record is cleared and the survey time is kept closest to the current survey dose.The long-term enrollment criteria were set as follows:(1)Outpatient visits meet the ICD-10 classification criteria for mental and behavioral disorders;(2)Patients taking psychiatric drugs during investigation.In the statistics section,statistical analysis was performed using SPSS 23.0 software.Results:1.Among the surveyed patients,the use rate of benzodiazepines was 34.8%.Compared with the use rate of benzodiazepines in the outpatients of the hospital in 2000 was 50% and the use rate in 2007 was48.85%,the use rate gradually decreased.The long-term use rate of benzodiazepines is 16.4%,and the combined rate of the two BZDs is2.3%.Among outpatients treated with BZDs,the long-term use rate was47.1%.2.Compared with different age groups,the use rate of benzodiazepine drugs(12.3%)and long-term use rate(1.8%)were the lowest in patients younger than 18 years old.With the increase of age,the use rate and long-term use rate of benzodiazepines gradually increased,and the use rate(55.7%)and long-term use rate(32.8%)of patients ?75years old were the highest;the difference was statistically significant.Among patients of different genders,female BZDs use rate and long-term use rate are higher than males,and the difference is statisticallysignificant.Among the patients diagnosed in different psychiatric departments,those diagnosed with sleep disorders had the highest rates of benzodiazepine use and long-term use.However,there are fewer patients with stress-related disorders and mental disorders in childhood and adolescence.3.Benzodiazepines were used between 4 and 2900 days,with a median of 100 days and a quartile interval of 240 days.There was no significant difference in the use time of BZDs in terms of gender,P =0.36.In the diagnosis of psychiatric disorders,patients diagnosed with sleep disorders took the longest medication,with a median duration of220 days and a quartile interval of 710 days;followed by patients diagnosed with schizophrenia,the median duration of 100 days and the interquartile range is 365 days.Patients diagnosed with emotional disorders in children and adolescents have the shortest medication time,with a median duration of 30 days and a quartile interval of 35 days.There was a statistically significant difference in the duration of using BZDs among patients diagnosed by different psychiatric departments,P<0.05.The average daily dose of BZDs users is 2.7 diazepam 5mg equivalent,which is lower than the average daily dose of long-term users of BZDs 3.4 diazepam 5mg equivalent.4.Among the various BZDs,the most common BZD is alprazolam(n = 152;37.2%),followed by clonazepam(n = 88;21.5%).Amonglong-term users,the frequency of clonazepam was also second only to alprazolam,and the proportion of patients who switched to long-term use of clonazepam was higher.Clonazepam is used more frequently than alprazolam,and a higher proportion of patients switch to long-term use.5.Compared with non-long-term users,the long-term users of BZDs in the survey unit have statistically significant differences in gender,age,marital status,occupation,and education level in terms of general demographic data;the age of long-term BZDs users larger,women account for more,most of the marital status is married,the occupation is mainly farmers,and the education level is mostly junior high school or below.In terms of disease-related information,there was no significant difference between the two groups in the onset form of mental illness and the number of previous psychiatric hospitalization.long-term users of BZDs had longer periods of mental illness than non-BZDs long-term users.The diagnoses of long-term users are mainly mood disorders,sleep disorders,schizophrenia and other psychiatric disorders,neurotic disorders,somatic forms and dissociative(transition)disorders.In terms of drug therapy,the difference between the two groups in the combined use of antipsychotic,antidepressant and emotion stabilizer(P < 0.05).6.The results of multivariate logistic regression analysis showed that females and old age are the risk factors for the long-term use of benzodiazepines.After adjusting for age,gender,and diagnosis,thepatient's marital status,occupation,and education level were not significantly related to the long-term use of benzodiazepines;the use of antidepressants was negatively related to the long-term use of BZDs;in specific drugs,the use of olanzapine is negatively correlated with long-term BZDs,the use of agomelatine is also negatively correlated with long-term BZDs,and quetiapine is associated with long-term BZDs.Conclusion:1.The utilization rate and long-term utilization rate of benzodiazepines in the psychiatric outpatients of this hospital were higher,34.8% and 16.4%,respectively.The utilization rate showed a gradual downward trend compared with 2000,2007 and 2018.The use rate and long-term use rate of benzodiazepines gradually increase with age,and women are higher than men.Use and long-term use of BZD is most common in patients diagnosed with sleep disorders.2.The median time of use of BZDs is 100 days,and the interquartile range is 240 days.The average daily dose of BZDs users is2.7 diazepam 5mg equivalent.Among the various BZDs,the most common BZDs in long-term user prescriptions are alprazolam;Clonazepam is used less frequently than alprazolam,and which has a higher proportion of patients switch to long-term use.3.The results of multivariate logistic regression analysis showed that women and old age were risk factors for the long-term use ofbenzodiazepines.After adjusting for age,gender,and diagnosis,the use of antidepressants is negatively correlated with long-term use of BZDs;in the specific drugs,the use of olanzapine,agomelatine is negatively correlated with long-term use of BZDs,and the quetiapine is related to the long-term use of BZDs.4.BZDs have a high proportion of long-term use.Just like any other drug,BZDs need to be carefully prescribed;the question of whether they should be used for a long time needs further discussion. |
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