Twenty‐year trends in benzodiazepine dispensing in the <scp>A</scp>ustralian population

Islam, M. Mofizul; Conigrave, Katherine M.; Day, Carolyn; Nguyen, Yvonne; Haber, Paul

doi:10.1111/imj.12315

Cited by 72 publications

(81 citation statements)

References 19 publications

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“…It is notable that such patterns of use aligns with Australian data showing alprazolam and diazepam to be among the most widely prescribed (Islam et al, 2014) and misused (Nielsen et al, 2008;Stafford & Burns, 2012) benzodiazepines, and also the most widely studied in relation to exploring the benzodiazepine-aggression link (Albrecht et al, 2014).…”

Section: Main Analysessupporting

confidence: 68%

Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

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Benzodiazepine-related aggression is understudied in the literature, in particular little is known about the motivational factors which may contribute to the development of this paradoxical response. The revised Reinforcement Sensitivity Theory provides a theoretical framework from which to understand the relevant underlying motivational processes. The current study aimed to identify the role of approach and avoidance motivational tendencies in the occurrence of benzodiazepine-related aggression. Data regarding benzodiazepine and other substance use, approach and avoidance motivation, and general and physical aggressive behaviour were collected via self-report questionnaires. Participants were a convenience sample (n = 204) who reported using benzodiazepines in the previous year. Participants were primarily male (62.7%), aged 18-51 years old. Hierarchical multiple regressions indicated that general and physical aggression were predicted by alprazolam use and Drive, a facet of approach motivation. Overall, lower diazepam use significantly predicted higher levels of general aggression. However, when diazepam-preferring participants were examined in isolation of the larger sample (23.5% of sample), problematic (dependent) diazepam use was associated with greater aggression scores, as was dependence risk for alprazolam-preferring participants (39.7% of sample). The findings highlight the importance of motivational factors and benzodiazepine use patterns in understanding benzodiazepine-related aggression, with implications for violent offender rehabilitation.

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Section: Main Analysessupporting

confidence: 68%

Motivational drive and alprazolam misuse: A recipe for aggression?

Albrecht

Staiger

Hall

et al. 2016

Psychiatry Research

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“…The PBS database captures all subsidized drug formulations, cost and amount of dispensing and period of drug dispensed by pharmacists for patients used at home [29]. Drug dispensed data on the PBS database were used in research studied and shown to represent trends of drug utilisation in Australia [30,31]. Rosiglitazone and pioglitazone are listed as subsidised drugs for all Australians therefore a complete record of dispensed medicines was obtained [3].…”

Section: Methodsmentioning

confidence: 99%

Utilisation trends of rosiglitazone and pioglitazone in Australia before and after safety warnings

Niyomnaitham

Page

Caze

et al. 2014

BMC Health Serv Res

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BackgroundA see on cardiovascular diseases and bladder cancer. The changes to the patterns of rosiglitazone and pioglitazone utilisation in Australia following the timing of these various health authority warnings such as the Australian Therapeutic Good Administration (TGA), European Medicines Agency (EMA) press releases or U.S. Food and Drug Administration (FDA) is unknown. This study investigated the utilisation patterns of rosiglitazone and pioglitazone in Australia before and after warnings of major drug authorities.MethodsWe evaluated rosiglitazone and pioglitazone dispensing using the Pharmaceutical Benefit Scheme (PBS) subsidised drug dispensing data for the Australian population from February 2004 to July 2012. The World Health Organisation Anatomic Therapeutic Chemical (ATC)/Defined Daily Dose (DDD) system was used to compare the drug utilisation patterns following the announcements of EMA, FDA, and TGA safety warnings, which first occurred in May 2007. The DDD/1000population/day were examined in a series of time-series regression analysis with the drug safety warnings specified as interventions.ResultsRosiglitazone utilisation increased steadily from 2004 until reaching a peak at 1.96/1000population/day in January 2007. Then rosiglitazone use decreased significantly after the initial EMA press release and FDA warning on cardiovascular risk in May 2007 (with a 15.04% average monthly decline, p-value <0.001), however use did not significantly decrease after the TGA warning or subsequent EMA and FDA warnings. Pioglitazone utilisation proceeded rosiglitazone in September 2008 and remained above 1.5/1000/day during 2009–2010. However, pioglitazone utilisation has slightly declined after the FDA, EMA, and TGA warnings related to bladder cancer.ConclusionsDrug safety warnings were associated with a decrease in rosiglitazone and pioglitazone utilisation in Australia. Rosiglitazone began to decline prior to TGA warnings in December 2007, which suggests that Australian prescribers may have acted in response to scientific evidence or international safety warnings (EMA, FDA), prior to the response of the TGA. Minor effects were observed after bladder cancer warnings on pioglitazone utilisation.

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“…Alprazolam became the second most popular drug, increasing more than eightfold. 1 Of particular concern are the patients who have been using benzodiazepines for more than six months. There are few indications for long-term therapy and they are generally controversial.…”

Section: Introductionmentioning

confidence: 99%