A retrospective review of the utilization of Benzodiazepines and Z-drugs in selected private community pharmacies in Namibia: 2017-2022
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Date
2024
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University of Namibia
Abstract
ackground: Overuse of benzodiazepines and Z-drugs is a considerable global public safety concern. In Namibia, despite the rising burden of mental illnesses, there is a paucity
in data regarding the utilization of benzodiazepines and Z-drugs.
Aim: The study aimed to determine the patterns and factors associated with the utilization
of benzodiazepines and Z-drugs in community pharmacies to guide medicine policy
reforms.
Methods: A descriptive multicenter longitudinal study as per the World Health
Organisation (WHO) medicine utilization design. The consumption data on
benzodiazepines and Z-drugs were retrospectively abstracted from the Unisolv®
dispensing software in selected pharmacies over a six-year period, 2017-2022.
Consequently, key informants were interviewed to identify the drivers of the use of
benzodiazepines and Z-drugs. Data were exported to SPSS v25 for analysis of the patterns
and factors of use of benzodiazepines and Z-drugs.
Results: Of the 10 selected-pharmacies, a total of 867 168 medicines were dispensed over
the six-year review period and 2% of these were benzodiazepines and Z-drugs
(n=17 840/867 168). Benzodiazepines (BZD) were the most dispensed (56%, n=9993/17
840), mainly to male patients (53.6%). The consumption of benzodiazepines and Z-drugs
was highest with Zolpidem (6.07 DDDs/1000 population) compared to other
benzodiazepines and Z-drugs. Over 54% of the dispensing encounters of benzodiazepines
and Z-drugs were repeat prescriptions of Z-drugs. From 2017 to 2022, the consumption
of Z-drugs increased but declined for benzodiazepines. Stakeholders identify the thematic
drivers of the use of benzodiazepines and Z-drugs as irrational prescribing, marketing, and
patient drug dependency.
Conclusion: Whilst, the consumption of benzodiazepines and Z-drugs in Namibia is lower
than global estimates, there is an increase in the use of benzodiazepines and Z-drugs in
the private health sector. There is a need for a regulatory framework and an education
strategy to empower pharmacists’ led interventions towards safe use of new
benzodiazepines and Z-drugs in the community pharmacies
Description
A thesis submitted in fulfillment of the requirements for the Degree of Master of Pharmacy in Clinical Pharmacy
Keywords
Dependency, Defined Daily Dose, Community pharmacies, Benzodiazepine and Z-drugs, Anatomical Therapeutic Chemical, Namibia, University of Namibia