Does hospitalisation affect hypnotic and anxiolytic drug prescribing?

Fagnoni, Philippe; Limat, Samuel; Haffen, Emmanuel; Hénon, T.; Jacquet, Micheline; Sechter, D.; Woronoff-Lemsi, Marie Christine

doi:10.1007/s11096-007-9097-z

Cited by 14 publications

(18 citation statements)

References 11 publications

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“…Microscopic studies have shown that specialists, in particular hospitalists, influence the prescribing behaviour of general practitioners (GP), directly by initiating treatments or indirectly by informing GPs about drugs [1][2][3][4][5][6][7][8][9][10][11]. Hospitalization of patients is also the occasion to take stock of their drug regimen and very frequently results in changes in medications [12][13][14][15][16][17][18][19][20][21]. However, some modifications are not clinically motivated and are only made to match the hospital formulary.…”

Section: Introductionmentioning

confidence: 99%

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

Gallini

Taboulet

2013

Brit J Clinical Pharma

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Aim To investigate the influence of hospital drug choices on pharmaceutical consumption for nine competitive classes in the surrounding community. Methods Ecological study. Data from the national survey on drugs in hospitals were used to extract quantities purchased by 25 French university hospitals for three ‘hospital classes’ (EPOs, LMWHs and setrons) and six ‘ambulatory classes’ (PPIs, ACEIs and ARBs, statins, α‐adrenoreceptor antagonists (AAAs) and selective serotonin re‐uptake inhibitors SSRIs). Re‐imbursed quantities for patients living in the hospital's catchment area were extracted from the national health insurance database. The relationship between the use of a brand in hospitals and their catchment areas was assessed using multivariate linear regressions with instrumental variables. Results An increase of 1 day of treatment with one brand in the hospital was associated with a significant increase of 2.8 days of treatment with the same brand in the catchment area. However, results strongly varied according to classes. An increase of 1 day of treatment in the hospital was significantly associated with an increase of 0.21 day for ‘hospital classes’ and 21.8 days for ‘ambulatory classes’ in the catchment area. Strong variations were seen across ‘ambulatory classes’. The effect was maximal for cardiovascular classes and not significant for AAAs and SSRIs. The size of the effect also varied with hospital characteristics: small and proximity university hospitals exerted the greatest influence. Conclusions Hospital consumption influences the use of drugs in the community. A significant effect was found, especially for competitive classes used on a long‐term basis. The economic consequences of these findings need to be addressed.

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Section: Introductionmentioning

confidence: 99%

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

Gallini

Taboulet

2013

Brit J Clinical Pharma

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“…In our retrospective study on prison patients, we observed a frequency of psychoactive substance use of 21.5% in 2000 that remained stable at 20.6% in 2004 and that was confirmed near 20% in 2008 (Jonker and Cabelguenne, personal communication). These results can be compared to the 25-30% frequency found in the French general population [2]. In France, in 2001, the rate of prisoners affected by mental disorders was estimated as 30% [16].…”

Section: Bdz Use In Psychiatric Practicementioning

confidence: 96%

“…Of these, the anxiolytics were found to be the most frequently used. Among the general French population, 25–30% is classed as occasional or regular users and 5–7% as chronic users of hypnotics or anxiolytics like benzodiazepine (BDZs) [2].…”

Section: Introductionmentioning

confidence: 99%

Impact of pharmacist and clinician dual intervention on prescribed benzodiazepines in prisoner patients: a retrospective study

Lerat

Cabelguenne

Lassia³

et al. 2010

Fundamental &Amp; Clinical Pharmacology

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High-dose benzodiazepine (BDZs) represents an important risk factor for dependence, particularly in a prison environment. In Lyon's prison, BDZs and/or opioid maintenance treatment are often prescribed to patients with mental disorders. The aim of this retrospective study was to assess the impact of psychiatrist and pharmacist collaboration on reducing the BDZs dose prescribed to prisoner patients. Since 2001, clinicians and pharmacists have been holding monthly meetings to develop prescribing guidelines and discuss those patients receiving high-dose BDZs. All prescribed psychotropic drugs were noted for each included patient in the control (before guidelines) and intervention groups. Criteria used to define each patient profile included age, diagnosis (mental disorder), and concomitant treatment (opioids, antidepressants). To compare each group, the daily dose of prescribed BDZs was used as a quantitative variable and expressed in diazepam equivalent. Four hundred and seventy-three patients were included, 222 in the control group and 251 in the intervention group. The two groups showed no difference in terms of diagnosis. The daily dose of BDZ was higher in the control group when all patients were considered (mean(CONTROL GROUP) = 46 mg in diazepam equivalent vs. mean(INTERVENTIION GROUP) = 34 mg) and for each of the following patient categories: 'mental disorder' (48 mg vs. 30 mg), 'no opioid treatment' (44 mg vs. 31 mg), 'buprenorphin treatment' (58 mg vs. 63 mg), 'no antidepressant treatment' (41 mg vs. 29 mg), and 'antidepressant treatment' (53 mg vs. 38 mg). The results of this retrospective study show the positive impact of multidisciplinary intervention on reducing the prescribed daily dose of BDZs. This experience confirms the positive impact that pharmacist feedback on prescriptions and the development of treatment guidelines by clinician and pharmacist collaboration have on improving the prescribing practice in a prison environment.

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“…Despite their risks, BZDs are widely prescribed in the general population. In France, 25%‐30% of the population are regular or occasional users and 5‐7% are chronic users . BZD consumption is particularly frequent in prison, where approximately 20% of male prisoners are treated by BZDs .…”

Section: What Is Known and Objectivementioning

confidence: 99%

Benzodiazepine dose reduction in prisoner patients: 15 years' teamwork between psychiatrists and pharmacists

et al. 2018

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Does hospitalisation affect hypnotic and anxiolytic drug prescribing?

Cited by 14 publications

References 11 publications

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

The influence of drug use in university hospitals on the pharmaceutical consumption in their surrounding communities

Impact of pharmacist and clinician dual intervention on prescribed benzodiazepines in prisoner patients: a retrospective study

Benzodiazepine dose reduction in prisoner patients: 15 years' teamwork between psychiatrists and pharmacists

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