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Comorbidities and concurrent medications increasing the risk of adverse drug reactions: prevalence in French benzodiazepine users

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

To estimate benzodiazepine prevalence of use and to quantify, in benzodiazepine users, the prevalence of comorbidities and concurrent medications increasing the risk of adverse drug reactions (ADRs).

Methods

Cross-sectional study performed using data from the French national healthcare insurance system. The prevalence of use was estimated by considering as users, patients who had at least one benzodiazepine reimbursement during the year 2013. Patients at increased risk for benzodiazepine ADRs were those who had (i) drug-drug interactions at risk for central nervous system and respiratory depression and (ii) comorbidities at risk for adverse respiratory effects, or for falls or fractures.

Results

Overall, the prevalence of benzodiazepine use in 2013 was estimated to be 13.8 %; it was higher among women and increased with age. This prevalence was 10.6 % for anxiolytic benzodiazepines, and 6.1 % for hypnotic benzodiazepines. Approximately half of the benzodiazepine users (48.1 %) were at increased risk for benzodiazepine ADRs; this proportion increased with age. Drug-drug interactions represented the most prevalent condition (39.3 % of benzodiazepine users). The drugs most frequently involved were opioids: analgesics (15.9 %) and antitussives (6.8 %). Overall, 11.3 % of benzodiazepine users had comorbidities at increased risk for adverse respiratory effects (13.9 % in those aged 65–79), and 7.0 % comorbidities at increased risk for falls or fractures (13.4 % in those aged ≥80).

Conclusions

This study found that benzodiazepine use remained high in France, and that roughly half of the users presented with comorbidities and concurrent medications increasing the risk of ADRs. These findings are of concern, given that benzodiazepines are frequently used, and especially among the elderly.

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Acknowledgments

The present study is part of the Drugs Systematized Assessment in real-liFe Environment (DRUGS-SAFE) research program that is funded by the French Medicines Agency (Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM); grants received for the year 2015: 900,000 euros). This program aims at providing an integrated system allowing the concomitant monitoring of drug use and safety in France. The potential impact of drugs (e.g., psychotropics), frailty of populations, and seriousness of risks drive the research program. This publication represents the views of the authors and does not necessarily represent the opinion of the French Medicines Agency.

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Authors and Affiliations

  1. University of Bordeaux, U1219, F-33000, Bordeaux, France

    Anne Bénard-Laribière, Pernelle Noize, Elodie Pambrun, Fabienne Bazin, Hélène Verdoux, Marie Tournier, Bernard Bégaud & Antoine Pariente

  2. INSERM, U1219, Bordeaux Population Health Research Center, Pharmacoepidemiology team, F-33000, Bordeaux, France

    Anne Bénard-Laribière, Pernelle Noize, Elodie Pambrun, Fabienne Bazin, Hélène Verdoux, Marie Tournier, Bernard Bégaud & Antoine Pariente

  3. CHU Bordeaux, Service de Pharmacologie Médicale, F-33000, Bordeaux, France

    Pernelle Noize, Bernard Bégaud & Antoine Pariente

  4. CIC Bordeaux CIC1401, F-33000, Bordeaux, France

    Pernelle Noize & Antoine Pariente

  5. Centre Hospitalier Charles Perrens, F-33000, Bordeaux, France

    Hélène Verdoux & Marie Tournier

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  1. Anne Bénard-Laribière
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Correspondence to Anne Bénard-Laribière.

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Contributions of authors’ statement

Anne Bénard-Laribière: Dr. Bénard-Laribière conceptualized and designed the study, interpreted the data, drafted the initial manuscript, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Elodie Pambrun, Fabienne Bazin: Mrs Pambrun and Mrs Bazin conceptualized and designed the study, acquired data and carried out the analysis, critically revised the manuscript, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Pernelle Noize, Hélène Verdoux, Marie Tournier, Bernard Bégaud, Antoine Pariente: Dr. Noize, Pr. Verdoux, Pr. Tournier, Pr. Bégaud, Pr. Pariente conceptualized and designed the study, interpreted the data, critically revised the manuscript, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Bénard-Laribière, A., Noize, P., Pambrun, E. et al. Comorbidities and concurrent medications increasing the risk of adverse drug reactions: prevalence in French benzodiazepine users. Eur J Clin Pharmacol 72, 869–876 (2016). https://doi.org/10.1007/s00228-016-2044-y

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