Ingunn Fride Tvete 1 , Trine Bjørner 2 , Tor Skomedal 3 Show Affiliations »
Abstract
BACKGROUND: Drug dependency may develop during long-term benzodiazepine use, indicated, for example, by dose escalation. The first benzodiazepine chosen may affect the risk of dose escalation. AIM: To detect possible differences in benzodiazepine use between new users of diazepam and oxazepam over time. DESIGN AND SETTING: This 5-year prescription database study included 19 747 new benzodiazepine users, inhabitants of Norway, aged 30-60 years, with first redemption for diazepam or oxazepam. METHOD: Individuals starting on diazepam versus oxazepam were analysed by logistic regression with sex, age, other drug redemptions, prescriber's specialty, household income, education level, type of work, and vocational rehabilitation support as background variables. Time to reach a daily average intake of ≥1 defined daily doses (DDD) over a 3-month period was analysed using a Cox proportional hazard regression model. RESULTS: New users of oxazepam had a higher risk for dose escalation compared with new users of diazepam. This was true even when accounting for differences in sociodemographic status and previous drug use (hazard ratio [HR] 1.33, 95% confidence interval = 1.17 to 1.51). CONCLUSION: Most doctors prescribed, according to recommendations, oxazepam to individuals they may have regarded as prone to and at risk of dependency. However, these individuals were at higher risk for dose escalation even when accounting for differences in sociodemographic status and previous drug use. Differences between the two user groups could be explained by different preferences for starting drug, DDD for oxazepam being possibly too low, and some unaccounted differences in illness. © British Journal of General Practice 2016.
BACKGROUND: Drug dependency may develop during long-term benzodiazepine use, indicated, for example, by dose escalation. The first benzodiazepine chosen may affect the risk of dose escalation. AIM: To detect possible differences in benzodiazepine use between new users of diazepam and oxazepam over time. DESIGN AND SETTING: This 5-year prescription database study included 19 747 new benzodiazepine users, inhabitants of Norway, aged 30-60 years, with first redemption for diazepam or oxazepam . METHOD: Individuals starting on diazepam versus oxazepam were analysed by logistic regression with sex, age, other drug redemptions, prescriber's specialty, household income, education level, type of work, and vocational rehabilitation support as background variables. Time to reach a daily average intake of ≥1 defined daily doses (DDD ) over a 3-month period was analysed using a Cox proportional hazard regression model. RESULTS: New users of oxazepam had a higher risk for dose escalation compared with new users of diazepam . This was true even when accounting for differences in sociodemographic status and previous drug use (hazard ratio [HR] 1.33, 95% confidence interval = 1.17 to 1.51). CONCLUSION: Most doctors prescribed, according to recommendations, oxazepam to individuals they may have regarded as prone to and at risk of dependency. However, these individuals were at higher risk for dose escalation even when accounting for differences in sociodemographic status and previous drug use. Differences between the two user groups could be explained by different preferences for starting drug, DDD for oxazepam being possibly too low, and some unaccounted differences in illness. © British Journal of General Practice 2016.
Entities: Chemical
Disease
Keywords:
Cox models; anxiety; benzodiazepines; diazepam; general practice; logistic models; oxazepam
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Substances： See more »
Year: 2016
PMID： 26965028 PMCID： PMC4809707 DOI： 10.3399/bjgp16X684385
Source DB: PubMed Journal: Br J Gen Pract ISSN： 0960-1643 Impact factor: 5.386