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Use of benzodiazepines and z-drugs not compliant with guidelines and associated factors: a population-based study

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Benzodiazepines and z-drugs are primarily indicated for the treatment of sleep disorders and anxiety symptoms. Their frequent long-term use contrasts with the international guidelines that limit treatment duration to a maximum of 4 weeks. The objective of this study was to assess the frequency of their use that was not in accordance with guidelines in the French general population between 2007 and 2012 and associated characteristics. A cohort of 67,550 benzodiazepine new users was set up in an exhaustive database for health-care reimbursements and representative of the French population. Benzodiazepine use not in accordance with guidelines was defined as the concomitant dispensation of several benzodiazepines, the dispensation of treatment over a period longer than recommended, or a new dispensing within the 2 months following the end of a previous treatment of maximum recommended duration, considering that French recommendations distinguish between hypnotic (4 weeks) and anxiolytic benzodiazepines (12 weeks). Benzodiazepine use not in accordance with guidelines was high, in about 30% of new hypnotic users and 20% of new anxiolytic users. Its frequency was stable over the study period. Associated characteristics were similar for new hypnotic or anxiolytic users, i.e.. older age, treatment initiation by a psychiatrist, presence of a chronic disease, hospitalization, or another psychotropic treatment. These findings provide a solid basis for establishing a public health policy to reduce benzodiazepine use not compliant with guidelines. They should be further explored in patients most at risk in the present study, e.g., patients treated by a psychiatrist.

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Acknowledgements

The authors thank Ray Cooke for copy-editing the manuscript. Arnaud Panes is a recipient of an award from the University of Bordeaux to fund his PhD.

Funding

This is independent research funded in-house by INSERM U1219, a public research unit, and by the French Medicines Agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM, ansm.sante.fr; Grant number: 2013-S081).

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Authors and Affiliations

  1. Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, University of Bordeaux, 33000, Bordeaux, France

    Arnaud Panes, Antoine Pariente, Anne Bénard-Laribière, Marie Tournier & Annie Fourrier-Réglat

  2. CHU Bordeaux, Pôle de Santé Publique, Service D’information Médicale, 33000, Bordeaux, France

    Antoine Pariente & Annie Fourrier-Réglat

  3. CIC1401, 33000, Bordeaux, France

    Régis Lassalle, Caroline Dureau-Pournin, Simon Lorrain & Annie Fourrier-Réglat

  4. Centre Hospitalier Charles Perrens, 33000, Bordeaux, France

    Marie Tournier

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  1. Arnaud Panes
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  2. Antoine Pariente
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Correspondence to Arnaud Panes.

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The manuscript does not contain any clinical studies or patient data. The authors declare that they have no conflict of interest.

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Panes, A., Pariente, A., Bénard-Laribière, A. et al. Use of benzodiazepines and z-drugs not compliant with guidelines and associated factors: a population-based study. Eur Arch Psychiatry Clin Neurosci 270, 3–10 (2020). https://doi.org/10.1007/s00406-018-0966-3

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  • DOI: https://doi.org/10.1007/s00406-018-0966-3

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