某精神专科医院2017-2019年门诊苯二氮类药物处方情况的回顾性分析

Retrospective Analysis of the Prescriptions of Benzodiazepines Tablets in the Outpatient Department of A Psychiatric Hospital From 2017 to 2019

目的:探讨某精神专科医院2017-2019年苯二氮类药物(Benzodiazepines,BZDs)片剂的门诊处方情况。方法:采用回顾性研究法,选取某省级精神专科医院2017—2019年门诊处方BZDs片剂的人群作为研究对象,以各BZDs平均日最大量(average daily maximum dose,ADMD)筛查出疑似依赖人群;应用自制的访谈纲要进行电话访谈以判断其是否存在药物依赖,并对BZDs依赖人群处方情况及特征进行分析。结果:2017-2019年累计处方BZDs共计110 041人次,门诊处方剂量前3位为阿普唑仑(2 458 800 mg)、艾司唑仑(2 014 500 mg)、氯硝西泮(6 705 600 mg);经ADMD筛选并保留得到BZDs疑似依赖人群共182例,其中男性占比49.5%,女性占比50.5%,阿普唑仑和氯硝西泮在单一用药人群中占最大比例;通过电话访谈共发现112例BZDs药物依赖患者,其中使用阿普唑仑和氯硝西泮的依赖人数最多,51~60岁这个年龄段所占比例最大,男性占比53.57%,女性占比46.43%,与处方总人群相比,BZDs依赖人群的性别差异不明显。另有4例符合多药依赖。结论:1.该院门诊2017-2019年苯二氮类药物处方呈逐年递增趋势;2.门诊处方BZDs片剂的人群中存在部分超剂量使用和依赖的情况;3.回顾性研究及根据标准化访谈纲要进行的电话访谈能有效发现门诊处方人群中的依赖患者,值得推广使用。

Objective: To analyze the use of benzodiazepines tablets in the outpatient department of the psychiatric hospital from 2017 to 2019. Methods: Through retrospective investigation and analysis, who prescribed the benzodiazepines tablets in the outpatient clinic of a provincial psychiatric hospital from 2017 to 2019 were selected as the object of the study. According to ADMD, to find out the people who were suspected to be BZDs dependence. A self-made interview outline was used to conduct a telephone interview to determine the BZDs dependence patients, and the prescription situation and characteristics of BZDs dependent population were analyzed. Results: A total of 110, 041 prescriptions of BZDs tablets in three years were collected from 2017 to 2019. It was found that the top three outpatient prescription doses in 3 years were alprazolam(2 458 800 mg), estazolam(2 014 500 mg) and clonazepam(6 705 600 mg). A total of 182 patients with suspected BZDs dependence were screened and retained by ADMD, and alprazolam and clonazepam accounted for the largest proportion of the single drug users. 112 BZDs dependence patients were found among them through telephone interview. Alprazolam and clonazepam were used most frequently in 112 drug dependence patients and it was found that there are 4 patients were multi-drug dependence. Conclusion: 1. The prescription of benzodiazepines in the outpatient clinic of the hospital is increasing year by year from 2017 to 2019;2. There is a certain degree of the phenomenon of drug overdose and drug dependence in outpatients who prescribed BZDs tablets;3. Retrospective study and telephone follow-up according to the standardized interview outline can effectively find the dependence patients in the outpatient prescription population, which is worth popularizing.