某教學醫院抗焦慮作用BZDs之處方合理性分析

Analysis of Anti-Anxiety BZDs Utilization in A Teaching-Hospital

黃玉如(Yu-Ju Huang) ； 張意宜(I-I Chang) ； 蘇渝評(Yu-Ping Su)

《臺灣臨床藥學雜誌》 20卷2期 (2012/06) Pp. 103-113

摘要

BZDs（Benzodiazepines）類藥物在醫療上使用相當普遍，但因易產生耐受性及依賴性，藥師有責任對此類藥品的使用狀態做持續性的監督與評估。本研究即針對一家每日門診量約2000人次的區域教學醫院，以有焦慮診斷且使用具抗焦慮作用BZDs之患者為對象，回溯性探討2007年鎮靜安眠藥物在門診處方劑量合理性及合併使用情形。結果顯示具焦慮診斷且使用抗焦慮作用BZDs的病人計2110人，其中女性1461人，男性649人，女性為男性之2.25倍。處方合計3048張，BZDs開立比例，前三名為oxazepam（31.8％），alprazolam（25.9％），fludiazepam（21.2％）。若以WHO所定義之每日處方劑量（Defined daily dose：DDD）分類，小於1DDD的處方佔85.1％，等於1DDD的處方佔10.6％，大於1DDD的處方佔4.3％。女性處方中劑量≧1DDD的有17.4％、男性則有11.0％。18歲以下的族群處方劑量中≧1DDD的比率最高，為25.6％，65歲以上老年人比率則為14.8％。年齡65歲以上者BZDs處方的平均每日劑量多約1/3-1/2 DDD，符合老年人的建議劑量。兩種BZDs同時處方的情形，約佔8.3％，各年齡層中同時處方兩種此類藥品的比率，以65歲以上的族群較高為10.8％。某院具抗焦慮作用BZDs藥物的處方多為合理使用，而老年人的處方劑量雖然多合乎建議，同時處方兩種以上抗焦慮作用BZD的比率卻相對較高，因此可再做後續的追蹤探討。

關鍵字

抗焦慮作用BZDs ； 鎮靜安眠藥物 ； 每日處方劑量(DDD)

並列摘要

BZDs(Benzodiazepines) are widely-used medicines for the treatment of anxiety. However, tolerance and dependence had been seen easily developed. The regimen of BZDs should be continuously monitored and evaluated, this is an important duty of pharmacist. A retrospective study was performed at a regional teaching hospital to investigate the prescription reasonableness of BZDs for anxiety patients who had outpatient visit in 2007. This study investigated 2110 patients whom were diagnosed as anxiety and BZDs were given. Of whom 1461 were female. A total of 3048 BZDs prescriptions were analyzed, the top three prescription drugs were oxazepam (31.8%), alprazolam (25.9%) and fludiazepam (21.2%). Using WHO defined DDD (defined daily dose) as a standard, 85.1% prescriptions dose were less than 1 DDD, 10.6% equal to 1DDD and 4.3% were more than 1DDD. Among female patients, the rate of prescriptions dose over 1DDD accounted for 17.4% while it was 11.0% among males. Age below 18 had the highest rate of prescription dose higher than 1DDD, which was 25.6%, and age above 65 was 14.8%. The daily dose range of BZDs for patients age above 65 met the recommended dose for elderly patients. About 8.3% of the prescriptions used two or more BZDs. The highest combination use was the age group above 65, accounted for 10.8%. From this study, we found that the utilization of BZDs in this hospital was reasonable. The prescription dose in elderly population met the recommended dose, but the relative higher combination use ratio should be keep an eye on.

並列關鍵字

anti-anxiety BZDs ； sedative-hypnotic drugs ； defined daily dose