Abstract
Introduction: Benzodiazepines belong to the group of anxiolytic sedatives and the most prescribed drugs in the world. Since these drugs have a potential for rapid anxiolytic effect and sedation, as well as driver capability impairment, there is a lack data of safety of benzodiazepines in traffic accidents. The aim: To make an assessment of the interconnection of time series of traffic accidents outcomes with time series of Benzodiazepine anxiolytic consumption in the Republic of Serbia. Methods: This paper is a part of IV phase academic study regarding the factors potentially affecting Benzodiazepine consumption and effects. We conducted a pharmaco-epidemiological time series analysis study of monthly sold Benzodiazepine anxiolytics in pharmacies and indicators of the crush road outcome on a monthly basis in the Republic of Serbia. The research was performed from January 2014 to December 2018. Results: Applying ARIMAX modeling we found a significantly link between DID of alprazolam with monthly total traffic accident, a high stochastic regression positive association of DID of Diazepam with the dependent variable monthly total traffic accident, the prediction of monthly fatalities of traffic accident or traffic accident with severe or slight injuries per total traffic accident we have demonstrated positive influence of DID of alprazolam in second-order autoregressive and moving average model with constant. In prediction of monthly fatalities traffic accident, a significant positive influence of DID of benzodiazepines (all together) in auto-regression model without constant was demonstrated. Conclusion: Consumption of both long-acting (over 12 h) and short-acting benzodiazepines together with all other causes highly determined the total number of traffic accidents on a monthly basis in 2014-2018 in the Republic of Serbia. An assessment of the interconnection of time series of traffic accidents outcomes with time series of Benzodiazepine anxiolytic consumption in the Republic of Serbia we found a significant positive influence of DID of benzodiazepines on traffic accidents outcomes. In total, all used benzodiazepines increase the number of fatal traffic accidents by 8.5 fold per month. Alprazolam additionally contributed with about ten percent (9.7%) to the frequency of traffic accidents on a monthly basis. Measures to prevent traffic accidents at all levels should be effective immediately in order to achieve positive results timely. The authors suggest that the great responsibility is raising awareness of compliance with traffic regulations with doctors who prescribe benzodiazepines.
Highlights
Benzodiazepines belong to the group of anxiolytic sedatives and the most prescribed drugs in the world [1, 2].Research and monitoring of benzodiazepine consumption / use is usually done in relation to the economic parameters that determine the stability and efficiency of the health system of countries
Descriptive statistics for the consumption of benzodiazepine anxiolytics are presented in Table 1, while traffic accident indicators are Variables diazepam
We found that there was a highly significant non-seasonal positive correlation of total traffic accidents depending on diazepam consumption (Table 3, Model 1), where it is seen that the total number of traffic accidents increases 5.9 fold depending on the total dose per inhabitants per day (DID) for diazepam on a monthly basis
Summary
Benzodiazepines belong to the group of anxiolytic sedatives and the most prescribed drugs in the world [1, 2].Research and monitoring of benzodiazepine consumption / use is usually done in relation to the economic parameters that determine the stability and efficiency of the health system of countries. In mentioned study authors gave critical analysis for liberal prescribing policy of benzodiazepines in the Republic of Serbia, which resulted in both enormous consumption of benzodiazepines and a positive trend of growth of their consumption during this period [2]. Since these drugs have a potential for rapid anxiolytic effect and sedation, as well as driver capability impairment, there is a lack data of safety of benzodiazepines in traffic accidents [3]. The authors used the IQIA international database for further multicenter comparison [4]
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