[Impact benzodiazepine dependence on the use of health services: senior' health study]. / Impact de la dépendance aux benzodiazépines sur l'utilisation des services de santé : étude sur la santé des aînés.

CONTEXT: Prolonged use of benzodiazepines increases the risk of addiction. The impact of this disease on the use of health services by older adults is not known. OBJECTIVE: Examine the association between benzodiazepine dependence and use of health services by older adults in Quebec. Methodology. The data comes from a survey conducted in Quebec in 2005-2006 with a representative sample of 707 elderly benzodiazepine consumption in the community. Benzodiazepine dependence was defined according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Revised Edition. The use of health services as measured by the incidence of consultations with health professionals over a period of 12 months. RESULTS: Seniors have consumed an average daily dose of 6.1 (± 7.6) mg diazepam equivalent to an average of 205 (± 130) days. The prevalence of benzodiazepine dependence has been estimated at 9.5%. This dependence increases the likelihood of consulting a specialist (odds ratio (OR) = 3.42; confidence interval 95% (CI 95%) = 1.38 to 8.50). Visits to other health professionals frontline were not significant. CONCLUSION: The results of this study suggest that the proportion of seniors who become addicted to benzodiazepines and do not use health services for this condition is important. There is a need to develop programs to improve the quality of benzodiazepine use in this population.

[Impact of benzodiazepine dependence on the use of health services: study of the health of seniors]. / Impact du sentiment de dépendance aux benzodiazépines sur l'utilisation des services de santé: étude sur la santé des aînés.

BACKGROUND: The use of benzodiazepines is common among seniors. This consumption can cause an addiction whose criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition revised (DSM-IV-TR) do not always apply to the situation of the elderly. This research seeks to examine the link between the feeling of benzodiazepine dependence and the use of health services by seniors. A secondary objective is to describe the use of benzodiazepines among seniors living in the community. METHOD: Data derive from a survey conducted in Quebec in 2005-2006 from a representative sample of 707 Francophones aged 65 and over living in the community. The feeling of benzodiazepine dependence was measured by a composite variable incorporating two questions inspired by the DSM-IV-TR. The use of health services was measured through the cumulative impact of consultation with health care professionals during a 12- month period. RESULTS: Older adults consumed a total of 745 benzodiazepines, including 117 (16.5%) which had a half-long life. The proportion of seniors who reported a feeling of dependence on benzodiazepines was estimated at 35.1 %. These seniors did not significantly make further use of health services for their addiction to benzodiazepines. CONCLUSION: The results of this study suggest that the use of benzodiazepines among seniors in Quebec is far from optimal. Moreover, the perceived need in addiction is not a significant factor in inducing seniors to use health services for the management of addiction. There is, therefore, a need for research to better understand the barriers associated with the use of health services by seniors addicted to benzodiazepines.

[Drug prescription practices in public medical centres in Gabon]. / La prescription de médicaments dans les centres médicaux publics de soins de santé primaires au Gabon.

CONTEXT OF THE PROBLEM: Inappropriate drug use constitutes a major problem of health programs in developing countries. The objective of this study was to describe and assess the quality of drug prescription practices in public medical centres in Gabon. METHOD: Using the Drug Use Prescribing Indicators developed collaboratively by the World Health Organization (WHO) and the International Network for Rational Use of Drugs (INRUD), we retrospectively evaluated the drugs prescribed during 1,200 randomly selected outpatient consultations that took place in 20 randomly selected public medical centres during the period between July 1, 1997 and June 30, 1998. RESULTS: A total of 3,054 drugs were prescribed during the 1,200 consultations under study, for an average of 2.6 (Standard Deviation: +/- 1.2) drugs per consultation. Of all the drugs prescribed, 13.5% (95% Confidence Interval (CI): 12.3-14.7) were prescribed under their international nonproprietary name (INN), while 57.1% (CI: 55.3-58.9) appeared on the national list of essential drugs. 64.5% (CI: 61.8-67.2) consultations resulted in the prescription of an antibiotic, while 21.8 % (CI: 19.5-24.1) led to the prescription of at least one injection. On average, six key drugs out of eleven were available in the medical centres visited. CONCLUSION: The results of this study suggest that drug prescriptions are far from optimal in the public medical centers in Gabon. Among other things, the prescription of drugs under their INN is very low. These findings highlight the need to develop and implement programs that seek to improve the quality of drug prescriptions in Gabon.