| Abstract [eng] |
Master's thesis by G. Jonušaitė, scientific supervisor Prof. Dr. K. Garuolienė: Changes in utilization of benzodiazepines and benzodiazepine related drugs in Lithuania. Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences Pharmacy Center -Vilnius. Aim: to evaluate the impact of measures to reduce benzodiazepine consumption in Lithuania. Objectives: to determine benzodiazepine consumption using electronic prescription data from 2017, 2021, and 2022, to evaluate the potential proportion of electronic prescriptions; to determine benzodiazepine consumption rates during these years; to assess benzodiazepine consumption trends; to evaluate the quality indicators for benzodiazepine prescription. Methodology: the study used electronic prescription data from the ESPBI IS e-prescription sub-system for 2017, 2021, and 2022, as well as the drug consumption report of the State Medicines Control Agency. Consumption was evaluated using the ATC/DDD methodology. The prevalence was calculated by the number of prescriptions per 1000 population during the study period. Consumption trends were evaluated based on TLK-10-AM disease codes, the active substance of the drug, the age and gender of the patients, and the qualification of the prescribing physician. Quality indicators were assessed based on the number of benzodiazepine and long-acting benzodiazepine prescriptions per 1000 patients aged over 65. Data were processed using MS Office Excel and statistical significance was assessed using the R Commander program. Results and conclusions: Between 2021 and 2022, there was an increase in benzodiazepine consumption based on electronic prescription data for issued drugs. Consumption of the N05BA group increased from 18.75 ATC/DDD in 2021 to 19.27 ATC/DDD in 2022. For the N05CD group, consumption increased from 2.33 ATC/DDD to 2.48 ATC/DDD during the same period, while for the N05CF group, consumption increased from 6.595 ATC/DDD to 7.477 ATC/DDD. The proportion of electronic prescriptions for the N05BA group increased by 11.37%, by nearly 6% for the N05CD group, and by 15.7% for the N05CF group. According to the State Medicines Control Agency report, the overall consumption of benzodiazepines decreased. It can be concluded that the measures taken to reduce benzodiazepine consumption were effective. The frequency of consumption, when analyzing only electronic prescriptions, increased from 289 prescriptions per 1000 inhabitants in 2021 for the N05BA group to 312 in 2022. For the N05CD group, the prevalence of prescriptions increased from 24 to 27, and for the N05CF group, the number of electronic prescriptions per 1000 inhabitants increased from 78 in 2021 to 88 in 2022. Over 60% of all prescriptions are for people over 65 years old, and more than 70% of all electronic prescriptions are issued to women. 90% of N05BA group prescriptions are for alprazolam, bromazepam, diazepam, and lorazepam. 90% of N05CD group prescriptions are for triazolam, and 70% of N05CF group prescriptions are for zolpidem. Benzodiazepines are most commonly prescribed to treat sleep disorders, anxiety, depression, and mental disorders caused by psychoactive substance use or disorders, caused by brain disease or damage. Approximately half of electronic prescriptions for these drug groups are issued by general practitioners, while the proportion of psychiatrist prescriptions ranges from 31-37%. Evaluating benzodiazepine prescription quality indicators for 2021 and 2022, it was found that over 1000 patients over the age of 65 received more than one benzodiazepine prescription, with the number increasing from 1211 in 2021 to 1328 in 2022. In 2021, 116 long-acting benzodiazepine prescriptions were issued per 1000 elderly patients, compared to 114.5 in 2022. |
