Benzodiazepīni ģimenes ārstu praksē.
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Benzodiazepīni (BDZ) ir plaši pielietota medikamentu grupa, kas tiek nozīmēta trauksmes, panikas lēkmes un miega traucējumu ārstēšanā. Tomēr to lietošana ir saistīta ar smagām blakusparādībām, piemēram, atkarības attīstība, kognitīva disfunkcija, paaugstināts autoavāriju un kritumu risks. Rekomendējamais lietošanas ilgums ir 2 līdz 4 nedēļām, bet sabiedrībā var redzēt pacientus, kas ilgstoši lieto benzodiazepīnus.
Darba mērķis: 1.Apskatīt medicīnas studentu attieksmi pret BDZ lietošanu un salīdzināt to ar ģimenes ārsta (ĢĀ) pieredzi. 2.Apskatīt BDZ lietotāju pieredzi sabiedrībā un salīdzināt to ar ĢĀ novērojumiem
Materiāli un metodes: Šķērsgriezuma pētījumā piedalījās 51 ĢĀ, 51 medicīnas students un 71 BDZ lietotājs. Dati tika ievākti izmantojot pašu sastādītas, anonīmas tiešsaites anketas. Dati tika apstrādāti, izmantojot Microsoft Excel un IBM SPSS 27.0 programmu.
Rezultāti: Pētījumā piedalījās 51 ĢĀ, lielākā daļa no tiem praktizē vairāk par 20 gadiem (64,7%), 51 pārsvarā 6. kursa medicīnas studenti (68,6%) un 71 BDZ lietotājs (93% sievietes, 7% vīrieši), vidējais vecums 34,6 gadi (SD=10.62). Vidējais BDZ lietotāju vecums ĢĀ praksēs bija 60-70 gadi (41,2%), savukārt, studenti uzskata, ka vidējais vecums ir 30-39 gadi (39,2%), p=<0,001. Studenti uzskata, ka vidējais BDZ lietošanas ilgums ir >4 nedēļām (37,3%), savukārt ĢĀ atzīmē, ka pārsvarā BDZ lieto pēc vajadzības (68,6%). BDZ lietošanas ilguma sadalījums ĢĀ praksē statistiski nozīmīgi atšķiras no studentu uzskatiem (p=0,001). Pirmās izvēles trauksmes un miega traucējumu ārstēšana ĢĀ praksē bija antidepresanti 31,1%. Savukārt studenti vairāk rekomendēja psihoterapiju un ne-medikamentozas metodes, salīdzinot ar ĢĀ. (p=0,003, p=0,035). ĢĀ vairāk piekrīt tam, ka BDZ lieto pārāk daudz (p=0,018). Studenti tendēti nepiekrist apgalvojumam, ka ne-medikamentoza trauksmes un bezmiega ārstēšana ir dārgāka un laikietilpīgāka, tāpēc BDZ nozīmēšana ir labākais variants.(p=0,002, p=0,004). Visvairāk izrakstītas BDZ ĢĀ praksē bija bromazepāms, alprazplāms (94,1%, 86,3%) bet sabiedrībā lietoja attiecīgi 67,6% un 70,4%.(p=<0,000, p=0,040). Vispārējā populācijā 21,1% lietoja BDZ vairāk par gadu, bet ĢĀ praksēs tikai 2%. Lietošanas ilguma sadalījums ĢĀ praksēs statistiski nozīmīgi atšķiras no vispārējās populācijas (p=0,005). 15,7% ĢĀ un tikai 4,2% lietotāju novēroja aizcietējumus pēc BDZ lietošanas, p=0,021. 47,1% ĢĀ un tikai 18,3% lietotāju novēroja reiboni p=0,001.
Secinājumi: Studenti uzskata, ka BDZ lietotāji ir jaunāki un lietošanas ilgums ir garāks, salīdzinot ar ĢĀ prakses pieredzi. Studenti dod priekšroku ne-farmakoloģiskai ārstēšanai, salīdzinot ar ĢĀ. Studenti vairāk nepiekrīt, ka cena un terapijas ilgums ir pietiekami pamatots iemesls, lai nozīmēt BDZ. Ģimenes ārstu izvēles BZD preparāti nesakrīt ar biežāk lietojamiem pacientu vidū. Kā arī ĢĀ un lietotājiem atšķiras pieredze attiecībā uz BZD blaknēm. BDZ terapijas ilgums ir garāks vispārējā populācijā, nekā ĢĀ praksēs.
Benzodiazepines (BDZ) are class of the drug that are widely used to treat anexiety and insomnia. However, long-term use (>4 weeks) can cause serious side effects, such as addiction, driving impairment and cognitive decline, in the public we can find people who are using BDZ more than a year. Aim: 1. to analyze student viewpoints on benzodiazepin (BDZ) and compare it with general practitioners (GP’s) experience. 2. to compare and analyse BZD users and GPs experiences. Materials and methods: A cross-sectional study was conducted. Data was collected from 51 GPs, 51 medical student and 71 BDZ uzer through anonymous self-administered online questionnaire. To compare and analyse groups were used Microsoft Excel and SPSS 27.0. Results: The study included 51 GPs, most of whom have been practicing for more than 20 years (64,7%), 51 mainly 6-year medical students (68,6%) and 71 BDZ users (93% female, 7% male), the mean age 34,6 (SD=10.62). Mean age of the BDZ users in GPs practice was 60-70 years old (41,2%), but the student assumed that the mean age is 30-39 years old (39,2%), (p=<0,001). The students assumed that the mean duration of the BDZ therapy is >4 weeks (37,3%), but the GPs noticed that most of the patients use BZD on an “as-needed basis” (68,6%). Distribution of the therapy duration in the GPs experience differs significantly from the students assumption (p=0,001). First-line anxiety treatment in the GPs experience was antidepressants 31,1%. But, the students were more likely to recommend psychotherapy and non-pharmacological treatment compared with the GPs (p=0,003, p=0,035). The students are more likely to disagree that non-pharmacological treatment of anxiety and insomnia are more expensive and time-consuming, that is why BDZ prescription is the better option (p=0,002, p=0,004). The most prescribed BDZs in GPs practice were Bromazepam and Alprazolam (94,1%, 86,3%), but in general population these drugs were used by respectivelly 67,6% and 70,4%. In general population 21,1% have been taking BDZs more than a year, but in GPs practice only 2%. Distribution of the therapy duration in the GPs experience differs significantly from general population (p=0,005). 15,7% GPs reported about constipation after BDZ use, but 4,2% users had this side effect (p=0,021). 47,1% GPs noticed dizziness, and only 18,3% had it (p=0,001). Conclusions: The students consider that BDZ users are younger and the duration of the therapy is longer compared with the real live experience of the GPs. Students prefer non-pharmacological treatment more than GPs. Students tend to disagree that the price and the duration of the therapy is a valid reason to prescribe BDZ. The most prescribed BZDs in GPs practice differ significanlty from the drugs that are used in general population. As well as there are differeces between the side effect experience in GPs practice and general population. The duration of the BDZ therapy was longer in general population than in GPs practice.
Benzodiazepines (BDZ) are class of the drug that are widely used to treat anexiety and insomnia. However, long-term use (>4 weeks) can cause serious side effects, such as addiction, driving impairment and cognitive decline, in the public we can find people who are using BDZ more than a year. Aim: 1. to analyze student viewpoints on benzodiazepin (BDZ) and compare it with general practitioners (GP’s) experience. 2. to compare and analyse BZD users and GPs experiences. Materials and methods: A cross-sectional study was conducted. Data was collected from 51 GPs, 51 medical student and 71 BDZ uzer through anonymous self-administered online questionnaire. To compare and analyse groups were used Microsoft Excel and SPSS 27.0. Results: The study included 51 GPs, most of whom have been practicing for more than 20 years (64,7%), 51 mainly 6-year medical students (68,6%) and 71 BDZ users (93% female, 7% male), the mean age 34,6 (SD=10.62). Mean age of the BDZ users in GPs practice was 60-70 years old (41,2%), but the student assumed that the mean age is 30-39 years old (39,2%), (p=<0,001). The students assumed that the mean duration of the BDZ therapy is >4 weeks (37,3%), but the GPs noticed that most of the patients use BZD on an “as-needed basis” (68,6%). Distribution of the therapy duration in the GPs experience differs significantly from the students assumption (p=0,001). First-line anxiety treatment in the GPs experience was antidepressants 31,1%. But, the students were more likely to recommend psychotherapy and non-pharmacological treatment compared with the GPs (p=0,003, p=0,035). The students are more likely to disagree that non-pharmacological treatment of anxiety and insomnia are more expensive and time-consuming, that is why BDZ prescription is the better option (p=0,002, p=0,004). The most prescribed BDZs in GPs practice were Bromazepam and Alprazolam (94,1%, 86,3%), but in general population these drugs were used by respectivelly 67,6% and 70,4%. In general population 21,1% have been taking BDZs more than a year, but in GPs practice only 2%. Distribution of the therapy duration in the GPs experience differs significantly from general population (p=0,005). 15,7% GPs reported about constipation after BDZ use, but 4,2% users had this side effect (p=0,021). 47,1% GPs noticed dizziness, and only 18,3% had it (p=0,001). Conclusions: The students consider that BDZ users are younger and the duration of the therapy is longer compared with the real live experience of the GPs. Students prefer non-pharmacological treatment more than GPs. Students tend to disagree that the price and the duration of the therapy is a valid reason to prescribe BDZ. The most prescribed BZDs in GPs practice differ significanlty from the drugs that are used in general population. As well as there are differeces between the side effect experience in GPs practice and general population. The duration of the BDZ therapy was longer in general population than in GPs practice.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Benzodiazepīni, ģimenes ārsti, studenti, Benzodiazepine, general practitioner, students