Primer dobre prakse ambulantnega predpisovanja zolpidema v Sloveniji v obdobju 2008-2016
Ključne besede:
zolpidem, starostniki, predpisovanje zdravil, spol, nespečnostPovzetek
Namen pričujoče raziskave je bil analizirati ambulantno predpisovanje v Sloveniji pogosto uporabljanega hipnotika zolpidema v obdobju od 2008 do 2016 po spolu in starosti, prikazati trende predpisovanja ter predpisovanje po regijah. Ne-benzodiazepinski hipnotiki so bili klasificirani po Anatomsko terapevtsko kemijski klasifikaciji (ATC) WHO; določeni so bili definirani dnevni odmerki (DDD) zdravil na 1000 prebivalcev na dan. Zbrani anonimizirani podatki so bili obdelani z deskriptivno statistiko, za analizo so bile narejene kontingenčne tabele, korelacija, Pearsonov test χ2, ANOVA in linearna regresija. Zolpidem je bil v glavnem predpisovan ženskam; največ receptov so prejele ženske v starostnih skupinah od 52 do 60 ter od 71 do 80 let. Pacienti, mlajši od 55 let, so prejeli 29,87 % receptov v primerjavi s pacienti, starejšimi od 55 let, ki so prejeli 70,13 % vseh receptov. Ugotovili smo, da so starejši od 55 let in ženske prejeli značilno več receptov za zolpidem. Analiza je pokazala razlike v predpisovanju zolpidema, razen po starosti in spolu, tudi po slovenskih regijah. Predpisovanje zolpidema je v konstantnem upadu od leta 2012, kar je primer dobre prakse in odraz upoštevanja smernic za zdravljenje nespečnosti.
Literatura
Agren, G. and Berensson, K. (2006). Healthy ageing. A challenge for Europe. The Swedish National Institute of Public Health, pp. 8–11.
Bazire, S. (2003). Psychotropic drug directory 2003/2004. The professionals' pocket handbook & aide memoire. London: The Both Press.
Bliwise, D. L. (2005). Normal aging. In: Kryger, M. H., Roth, T. and Dement, W. C. (eds.). Principles and practice of sleep medicine. 4th ed. Philadelphia, PA: Elsevier Saunders, pp. 24–38.
Bogan, R. K. (2008). Treatment options for insomnia: pharmacodynamics of zolpidem extendedrelease to benefit next-day performance. Postgrad Med, 120, No. 3, pp. 161–171.
Databases act in the area of healthcare (2000). Official Gazette no. 65/00. Retrieved on 08/11/2015 from the internet: http://www.pisrs.si/Pis.web/pregledPredpisa?id=ZAKO1419.
Di Bonaventura, M., Richard, L., Kumar, M., Forsythe, A., Flores, N. M. and Moline, M. (2015). The association between insomnia and insomnia treatment side effects on health status, work productivity, and healthcare resource use. Retrieved on 12/07/2015 from the internet: http://www.plosone.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pone.0137117&representation=PDF.
Diem, S. J., Ewing, S. K., Stone, K. L., Ancoli-Israel, S., Redline, S. and Ensrud, K. E. (2014). Use of non-benzodiazepine sedative hypnotics and risk of falls in older men. J Gerontol Geriatr Res, 3, No. 3, pp. 158–171.
Driver, H. S. (2012). Gender differences in sleep. In: Morin, C. M. and Espie, C. A. (eds.). Oxford Handbook of Sleep and Sleep Disorders. 1st ed. Oxford: Oxford University Press. pp. 266–288.
Guidozzi, F. (2015). Gender differences in sleep in older men and women. Climacteric, 18, No. 5, pp. 715–721.
Hoque, R. and Chesson, A. (2009). Zolpidem-induced sleepwalking, sleep related eating disorder, and sleep-driving: fluorine-18-flouodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem. J Clin Sleep Med, 5, No. 5, pp. 471–476.
Internal data. National Institute of Public Health. Ljubljana, 2017.
Jehan, S., Masters-Isarilov, A., Salifu, I., Zizi, F., Jean-Louis, G., Pandi-Perumal, S. R., Gupta, R., Brzezinski, A. and McFarlane, S. I. (2015). Sleep Disorders in Postmenopausal Women. Retrieved on 12/02/2015 from the internet: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621258/pdf/nihms724718.pdf.
Jelenc, M. (2013). Characteristics of prescriptions of medicines for patients with the highest number of prescriptions in Slovenia in 2011. Diploma thesis. Ljubljana, Medical Faculty.
Kajiwara, A., Yamamura, M., Murase, M., Koda, H., Hirota, S., Ishizuka, T., Morita, K., Oniki, K., Saruwatari, J. and Nakagawa, K. (2015). Aging Ment Health, 14, pp. 1–5.
Kang, D. Y., Park, S., Rhee, C. W., Kim, Y ., Choi, N. K., Lee, J. and Park, B. J. (2012). Zolpidem use and risk of fracture in elderly insomnia patients. J Prev Med Pub Health, 45, pp. 219–226.
Kapil, V., Green, J. L., Le Lait, C., Wood, D. M. and Dargan, P. I. (2014). Misuse of benzodiazepines and Z-drugs in the UK. Br J Psychiatry, 205, No. 5, pp. 407–408.
Kaplan, H. I. and Sandock, B. J. (1996). Pocket handbook of psychiatric drug treatment. 2nd ed. Baltimore: Williams & Wilkins.
Kostnapfel Rihtar, T. and Albreht, T. (Eds.) (2017).The consumption of medicines in Slovenia in 2016. National Institute of Public Health. Retrieved on 05/09/2017 from the internet: http://www.nijz.si/sl/publikacije/poraba-zdravil-v-sloveniji-v-letu-2016.
Krishnan, V. and Collop, N. A. (2006). Gender differences in sleep disorders. Curr Opin Pulm Med, 12, No. 6, pp. 383–389.
Leban,V. and Brvar, M. (2015). Drug poisoning. Farm Vestn, 66, pp. 306–312.
Lin, F. Y., Chen, P. C., Liao, C. H., Hsieh, Y. W. and Sung, FC. (2014). Retrospective population cohort study on hip fracture risk associated with zolpidem medication. Sleep, 37, No. 4, pp. 673–679.
MacFarlane, J., Morin, C. M. and Montplaisir J. (2014). Hypnotics in insomnia: the experience of zolpidem. Clinical Therapeutics, 36, No. 11, pp. 1676–1701.
McCall, W. V. (2004). Sleep in the elderly: burden, diagnosis, and treatment. Prim Care Companion J Clin Psychiatry, 6, pp. 9–20.
Morin, C. M., Beaulieu-Bonneau, S., Ivers, H., Vallieres, A., Guay, B., Savard, J. and Merette, C. (2014). Speed and trajectory of changes of insomnia symptoms during acute treatment with cognitive-behavioral therapy, singly and combined with medication. Sleep medicine, 15, pp. 701–707.
Morin, C. M., LeBlanc, M., Daley, M., Gregoire J. P. and Mérette, C. (2006). Epidemiology of insomnia: Prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors. Sleep Med, 7, pp. 123–130.
Munch, M., Cajochen, C. and Wirz-Justice, A. (2005). Sleep and circadian rhythms in ageing. Zeitschrift fur gerontologie und geriatrie, 38, pp. 121–123.
Obayashi, K., Araki, T., Nakamura, K., Kurabayashi, M., Nojima, Y., Hara, K., Nakamura, T. and Yamamoto, K. (2013). Risk of falling and hypnotic drugs: Retrospective study of inpatients. Drugs, 13, pp. 159–164.
Olubodun, J. O., Ochs, H. R., von Moltke, L. L., Roubenoff, R., Hesse, L. M., Harmatz, J. S., Shader, R. I. and Greenblatt, D. J. (2003). Pharmacokinetic properties of zolpidem in elderly and young adults: possible modulation by testosterone in men. Br J Clin Pharmacol, 56, pp. 297–304.
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C. and Sateia, M. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med, 4, pp. 487–504.
Stahl, S. M. (2000). Essential psychopharmacology: neuroscientific basis and practical applications. 2nd edition. USA: Cambridge University Presss.
Stewart, R., Besset, A. and Bebbington, R. et al. (2006). Insomnia comorbidity and impact and hypnotic use by age group in a natonal survey population aged 16 to 74. Sleep, pp. 1391–1397.
Tomšič, S., Kofol Bric, T., Korošec, A. and Maučec Zakotnik, J. (2014). Challenges in improving behaviour and health. CINDI Project. Ljubljana, NIPH.
Victorri-Vigneau, C., Gerardin, M., Rousselet, M., Guerlais, M., Grall-Bronnec, M. and Jolliet P. (2014). An update on zolpidem abuse and dependence. J Addict Dis, 33, No.1, pp. 15–23.
Wong, E. and Nguyen, T. V. (2014). Zolpidem use in the elderly and recent safety data. J Nurse Practitioners, 10, No. 2, pp. 140–141.
World Health Organization Collaborating Centre for Drug Statistics Methodology. DDD Definition and General Considerations. Retrieved on 08/08/2015 from the internet: http://www.whocc.no/ddd/definition_and_general_considera/.
