{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:57:33Z","timestamp":1791413853613,"version":"4.3.3"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2023\/00469-0"],"award-info":[{"award-number":["2023\/00469-0"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Benzodiazepines are frequently prescribed to treat anxiety and insomnia, but long-term use has been associated with the development of dependence, tolerance, and cognitive decline, especially among older adults. This study aimed to investigate the pattern of consumption and factors associated with inappropriate prescribing of benzodiazepines in primary health care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a cross-sectional analytical study, using dispensing records of diazepam, clonazepam, and nitrazepam from public pharmacies in a Brazilian municipality between 2018 and 2022. Metrics for benzodiazepine consumption were DDD (Defined Daily Dose) and DDD\/1000PD (per 1000 population per day). Long-term\/prolonged benzodiazepine use was defined as consuming at least 90 DDD and at least 2 dispensations per year. To ascertain associations between long-term use and predictor variables, a multivariate logistic regression model was utilized.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Findings<\/jats:title>\n<jats:p>A total of 40402 participants were included, with an average age of 55 years (SD = 0.30), 38.5% were older aged. Diazepam and nitrazepam exceeded the daily dose recommended. There was a reduction in diazepam consumption during the study period, as calculated by DDD\/1.000PD, while the consumption of other benzodiazepines remained stable. However, a significant increase in diazepam consumption is noted when considering the last decade. Prolonged use was observed in 29.1% of participants, with a significant prevalence among the older people (34.8% of them were long-term users) and advancing age was identified as a risk factor for long-term use. Higher PDDs were also associated with long-term use and aging. Participants who used different benzodiazepines during the period had a higher risk of prolonged use.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>These results provide insights into the prevalence of problematic utilization of benzodiazepines in primary health care. Authorities and health care providers must take steps to encourage gradual cessation of prolonged benzodiazepine prescriptions and the embrace of suitable strategies for addressing anxiety and insomnia within primary health care settings.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0309984","type":"journal-article","created":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T17:43:24Z","timestamp":1725471804000},"page":"e0309984","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Consumption patterns and factors associated with inappropriate prescribing of benzodiazepines in Primary Health Care settings"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9551-4711","authenticated-orcid":true,"given":"Maria Ol\u00edvia","family":"Barboza Zanetti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iara","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falia Casanova","family":"Durante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana Rossi","family":"Varallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo R\u00e9gis Leira","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Inocenti","family":"Miasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"pone.0309984.ref001","volume-title":"Depression and Other Common Mental Disorders: Global Health Estimates","author":"World Health Organization","year":"2017"},{"key":"pone.0309984.ref002","author":"PC Hallal","year":"2023","edition":"1"},{"issue":"1","key":"pone.0309984.ref003","first-page":"83","article-title":"Consumption of anxiolytic benzodiazepines: a correlation between SNGPC data and sociodemographic indicators in Brazilian capitals","volume":"21","author":"AJP Azevedo","year":"2016","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"},{"issue":"6","key":"pone.0309984.ref004","first-page":"e00097718","article-title":"Use and abuse of benzodiazepines in primary healthcare: professional practices in Brazil and Cuba","volume":"35","author":"C Fegadolli","year":"2019","journal-title":"Cad Saude Publica"},{"key":"pone.0309984.ref005","first-page":"10","article-title":"Benzodiazepines utilization in Brazilian older adults: a population-based study","volume":"56","author":"MBO Freire","year":"2022","journal-title":"Rev Saude Publica"},{"issue":"5","key":"pone.0309984.ref006","first-page":"339","article-title":"Deprescribing benzodiazepine receptor agonists Evidence-based clinical practice guideline","volume":"64","author":"K Pottie","year":"2018","journal-title":"Can Fam Physician"},{"issue":"7","key":"pone.0309984.ref007","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1111\/jgs.18372","article-title":"American Geriatrics Society 2023 updated AGS Beers Criteria\u00ae for potentially inappropriate medication use in older adults","volume":"71","author":"By the 2023 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel","year":"2023","journal-title":"J Am Geriatr Soc"},{"issue":"12","key":"pone.0309984.ref008","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"12","author":"E Von-Elm","year":"2014","journal-title":"International Journal of Surgery"},{"issue":"6","key":"pone.0309984.ref009","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1002\/pds.4551","article-title":"Trends in the long-term use of benzodiazepine anxiolytics and hypnotics: A national register study for 2006 to 2014","volume":"27","author":"T Kurko","year":"2018","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"pone.0309984.ref010","unstructured":"Brazil. 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