Outpatient Prescribing Trends of Benzodiazepines and Z-drugs in a General Hospital in Singapore

Abstract

Background The use of benzodiazepines and z-drugs in clinical practice is a double-edged sword. There is a paucity of literature studying the prescribing trends of benzodiazepines and z-drugs in Singapore. Objective The objective of this study is evaluate the outpatient prescribing trends of oral benzodiazepines and z-drugs in a general hospital in Singapore over a 9 years period, from 2005 to 2013. Methods Data was obtained from the electronic records of all outpatient benzodiazepine and z-drug prescriptions over the study period. The parameters studied were daily dose (in mg/day), duration (in days) and total dose (in mg) of the drug of interest in each prescription. Stratification of these parameters by age groups and gender of patients was performed. A multivariate linear regression model was used to analyze the prescribing patterns across time while adjusted for confounders. Results There was a significant drop in the number of benzodiazepine and z-drug prescriptions between 2011 and 2013. The specified parameters of Alprazolam, Diazepam and Lorazepam prescriptions showed steep drops between 2011 and 2013, while those of Midazolam increased considerably over the same period. Full Linear regression analysis for mean total dose showed negative coefficients for Alprazolam, Diazepam, Lorazepam, Zopiclone and Zolpidem prescriptions and a positive coefficient for Midazolam prescriptions. Conclusion There is preliminary evidence for an overall drop in the prescribing trend of benzodiazepines and z-drugs; this study is a stepping-stone for much needed future research in this area.