Benzodiazepine and Z-Drug Use in Switzerland: Prevalence, Prescription Patterns and Association with Adverse Healthcare Outcomes

Salome Landolt,1 Thomas Rosemann,1 Eva Blozik,1,2 Beat Brüngger,2 Carola A Huber1,2 1Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland; 2Department of Health Sciences, Helsana Insurance Group, Zürich, SwitzerlandCorrespondence: Carola A HuberHelsana Insurance Group, P.O. 8081, Zürich, SwitzerlandTel + 41 43 340 6341Fax +41 43 340 0434Email carola.huber@helsana.chPurpose: This study aimed to give a nationwide comprehensive picture of the prevalence and prescription patterns of benzodiazepines (BZ) and Z-drugs (ZD) in Switzerland and to analyze the association with adverse health care outcomes.Patients and Methods: A population-based, cross-sectional study was conducted, using a large health insurance database in Switzerland. Records from all adult patients with ≥ 1 prescription for a benzodiazepine and/or a Z-drug in 2018 were included. We calculated the prevalence of BZ and ZD user (extrapolated to the Swiss general population), the number of prescriptions and the type of provider (among each BZ and ZD only user). Multivariate logistic regression models were performed to estimate the association between drug prescription and the risk of hospitalization in different healthcare settings.Results: Of a total of 844ʹ692 patients, 95ʹ179 had ≥ 1 BZ and/or ZD prescription in 2018. The extrapolated one-year prevalence for the general Swiss population was 8.1% for a BZ prescription, 3.5% for a ZD prescription, and 10.5% for a BZ and/or ZD prescription, and continuously increased with age. The majority of the elderly (over 65 years) had ≥ 1 prescription (BZ: 51.9%; ZD: 56.9%; BZ and/or ZD: 53.5). The proportion of patients with ≥ 6 prescriptions per year was 23.1% for BZ only user and 35.2% for ZD only user. Most patients had ≥ 1 prescription from a general practitioner. Regression models showed a higher likelihood to be admitted to acute c