Prolonged use of benzodiazepine in primary health care: evaluation of effectiveness, dependence and cognitive function.

IF 3.1 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Opinion on Drug Safety Pub Date : 2025-09-29 DOI:10.1080/14740338.2025.2567587

Júlia Casanova Durante, Amanda Gomes Dantas, Fabiana Coelho Inouye, Fabiana Rossi Varallo, Leonardo Régis Leira Pereira, Adriana Inocenti Miasso, Marília Silveira de Almeida, Maria Olívia Barboza Zanetti

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引用次数: 0

Abstract

Background: Anxiety and insomnia are global health challenges often managed in Primary Health Care (PHC). Benzodiazepines (BZD) are commonly prescribed, but prolonged use increases risks such as cognitive impairment, dependence, and tolerance. This study assessed PHC users with prolonged BZD use for anxiety or insomnia, focusing on dependence, effectiveness, and cognitive function.

Research design and methods: A cross-sectional study was conducted with 144 prolonged BZD users in PHC. Data collection included sociodemographic and clinical questionnaires, alongside instruments assessing dependence, cognition, insomnia, and anxiety. Logistic regression analyses were performed.

Results: Participants had a mean age of 64.3 years (SD=10.97) and average BZD use duration of 10 years. Prevalence of polypharmacy (54.9%), high anticholinergic load (41%), falls (29.2%), and alcohol use (33.4%) was observed. Falls were linked to severe problematic BZD use, while aging, cognitive impairment, mild insomnia, and lower anxiety were linked to less severe use. Severe insomnia correlated with extreme concerns about medication availability. Older age, white race, and better insomnia or anxiety profiles reduced non-adherence risks, whereas illiteracy increased them. Severe withdrawal symptoms elevated fall risk.

Conclusions: Findings stress the need for BZD deprescription.

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苯二氮卓类药物在初级卫生保健中的长期使用：有效性、依赖性和认知功能的评价

背景：焦虑和失眠是全球性的健康挑战，通常在初级卫生保健（PHC）中得到管理。苯二氮卓类药物（BZD）是常用处方，但长期使用会增加认知障碍、依赖和耐受性等风险。本研究评估了长期服用BZD的PHC使用者的焦虑或失眠，重点关注依赖性、有效性和认知功能。研究设计与方法：对144名长期服用BZD的PHC患者进行了横断面研究。数据收集包括社会人口学和临床问卷，以及评估依赖性、认知、失眠和焦虑的工具。进行逻辑回归分析。结果：参与者平均年龄为64.3岁（SD=10.97），平均BZD使用时间为10年。多药（54.9%）、高抗胆碱能负荷（41%）、跌倒（29.2%）和饮酒（33.4%）的患病率。跌倒与严重的BZD使用有关，而衰老、认知障碍、轻度失眠和较低的焦虑程度与不太严重的BZD使用有关。严重的失眠症与对药物供应的极度担忧有关。年龄较大、白种人和较好的失眠或焦虑状况降低了不遵守规定的风险，而文盲则增加了这一风险。严重的戒断症状会增加跌倒的风险。结论：研究结果强调了BZD解处方的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Opinion on Drug Safety 医学-药学

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Opinion on Drug Safety ranks #62 of 216 in the Pharmacology & Pharmacy category in the 2008 ISI Journal Citation Reports. Expert Opinion on Drug Safety (ISSN 1474-0338 [print], 1744-764X [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of drug safety and original papers on the clinical implications of drug treatment safety issues, providing expert opinion on the scope for future development.