Long-term benzodiazepine and Z-drugs use in England: a survey of general practice

TY - JOUR

T1 - Long-term benzodiazepine and Z-drugs use in England

T2 - a survey of general practice

AU - Davies, James

AU - Rae, Todd C.

AU - Montagu, Luke

PY - 2017/9/1

Y1 - 2017/9/1

N2 - AbstractBackground Current British National Formulary (BNF) guidelines state that benzodiazepines and zolpidem, zopiclone, and zaleplon, commonly known as Z-drugs (BZD), be prescribed for no more than 4 weeks, although anecdotal data suggest that many patients are prescribed BZDs for much longer. As there are no recent, evidence-based estimates of long-term (>12 months) BZD use in England, the scale of this potential problem is unknown.Aim To produce the first reliable, evidence-based estimate of long-term BZD use in England. Design and setting Estimates of English long-term BZD use were projected from data obtained from a survey conducted in 2014–2015 by the Bridge Project, a prescribed-drug withdrawal support charity in the North of England (Bradford).Method Percentages of long-term users of BZD were derived from the survey, by sampling primary care GP surgeries with around 100 000 registered patients, and these were applied to England-wide NHS patient numbers. The data were filtered to exclude the very young and old, and those with other health issues.Results The mean percentage of registered patients prescribed BZDs for more than a year in the survey sample is 0.69% (95% confidence interval [CI] = 0.54 to 0.84). Applying this value to national patient numbers yields a mean projection of 296 929 (95% CI = 232 553 to 361 305) long-term users of BZD in England. The data also suggest that as many as 119 165 of these patients may be willing to accept prescribed drug dependency withdrawal services.Conclusion More than a quarter of a million people in the UK are likely to be taking highly dependency-forming hypnotic medication far beyond the recommended time scales. As there is evidence that long-term use of BZDs causes adverse physiological and neurological effects, and protracted withdrawal (with associated complications), this represents a serious public health problem.© 2017, British Journal of General Practice. The attached document (embargoed until 01/09/2018) is an author produced version of a paper published in the British Journal of General Practice, uploaded in accordance with the publisher’s self-archiving policy. The final published version (version of record) is available online at https://doi.org/10.3399/bjgp17X691865. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.

AB - AbstractBackground Current British National Formulary (BNF) guidelines state that benzodiazepines and zolpidem, zopiclone, and zaleplon, commonly known as Z-drugs (BZD), be prescribed for no more than 4 weeks, although anecdotal data suggest that many patients are prescribed BZDs for much longer. As there are no recent, evidence-based estimates of long-term (>12 months) BZD use in England, the scale of this potential problem is unknown.Aim To produce the first reliable, evidence-based estimate of long-term BZD use in England. Design and setting Estimates of English long-term BZD use were projected from data obtained from a survey conducted in 2014–2015 by the Bridge Project, a prescribed-drug withdrawal support charity in the North of England (Bradford).Method Percentages of long-term users of BZD were derived from the survey, by sampling primary care GP surgeries with around 100 000 registered patients, and these were applied to England-wide NHS patient numbers. The data were filtered to exclude the very young and old, and those with other health issues.Results The mean percentage of registered patients prescribed BZDs for more than a year in the survey sample is 0.69% (95% confidence interval [CI] = 0.54 to 0.84). Applying this value to national patient numbers yields a mean projection of 296 929 (95% CI = 232 553 to 361 305) long-term users of BZD in England. The data also suggest that as many as 119 165 of these patients may be willing to accept prescribed drug dependency withdrawal services.Conclusion More than a quarter of a million people in the UK are likely to be taking highly dependency-forming hypnotic medication far beyond the recommended time scales. As there is evidence that long-term use of BZDs causes adverse physiological and neurological effects, and protracted withdrawal (with associated complications), this represents a serious public health problem.© 2017, British Journal of General Practice. The attached document (embargoed until 01/09/2018) is an author produced version of a paper published in the British Journal of General Practice, uploaded in accordance with the publisher’s self-archiving policy. The final published version (version of record) is available online at https://doi.org/10.3399/bjgp17X691865. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.

U2 - 10.3399/bjgp17X691865

DO - 10.3399/bjgp17X691865

M3 - Article

SN - 0960-1643

VL - 67

SP - e609-e613

JO - BRITISH JOURNAL OF GENERAL PRACTICE

JF - BRITISH JOURNAL OF GENERAL PRACTICE

IS - 662

ER -