title: Use of addictive anxiolytics and hypnotics in a national cohort of incident users in Norway.
abstract: OBJECTIVE
  To examine (1) incidence rates for treatment with addictive anxiolytics and hypnotics in Norway, (2) the proportions initiated by general practitioners (GPs), psychiatrists, and other physicians, and (3) the course of the treatment among incident users during a 3.5 year follow-up period.
  
  
  METHODS
  Data on all prescriptions of anxiolytics (ATC code N05B) and hypnotics (N05C) dispensed to the general population from 1 January 2004 to 31 August 2009 were extracted from the Norwegian Prescription Database and merged with data about GPs from the Norwegian Regular General Practitioner Scheme.
  
  
  RESULTS
  One-year incidence rates per 1,000 inhabitants were 18.2 for anxiolytics, 24.5 for hypnotics, and 35.4 for anxiolytics and hypnotics combined. GPs and psychiatrists initiated the treatment to 75.4 and 2.4%, respectively. Only 30.8% received short-term treatment as recommended. Long-term use (11.8%) and heavy use (1.4%) were most common for treatments initiated by a GP, but the risk both of long-term and of heavy use was highest for patients initially treated by a psychiatrist. The amount redeemed during the first quarter was the strongest predictor of long-term use and of heavy use. However, even during the quarter with highest drug consumption, 81.5% of the patients received <1 DDD/day.
  
  
  CONCLUSIONS
  This study indicates that physicians' prescribing strategy towards initial users is crucial in order to prevent inappropriate drug use. There is a need to implement relevant guidelines and systems for structured clinical audits in general practice.
authors.affiliation: Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. svein.kjosavik@isf.uib.no
authors.forename: Svein R
authors.initials: SR
authors.lastname: Kjosavik
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruths
authors.forename: Steinar
authors.initials: S
authors.lastname: Hunskaar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009664:Norway; D010820:Physicians / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives