A carregar...
Publicação
Evolução do uso de benzodiazepínicos em Portugal: uma análise de 2013 a 2025
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| Projeto de pós-graduação_2023113680 | 2.71 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
A saúde mental constitui atualmente um dos principais desafios de saúde pública, assumindo particular relevância em Portugal, que apresenta uma das mais elevadas prevalências de perturbações psiquiátricas na Europa. Entre estas, as perturbações de ansiedade destacam-se pela sua elevada frequência e impacto na qualidade de vida, estando frequentemente associadas à utilização de benzodiazepinas. Neste contexto, a monitorização dos padrões de utilização destes medicamentos é essencial para apoiar estratégias de prescrição racional e políticas de saúde. O objetivo deste estudo foi avaliar as tendências de consumo de benzodiazepinas em Portugal entre 2013 e 2025, com base em dados de dispensa em farmácia comunitária. Foi realizado um estudo observacional, ecológico e retrospetivo da utilização de benzodiazepinas ansiolíticas, sedativas/hipnóticas e antiepiléticas, recorrendo à base de dados da Health Market Research® (HMR), que abrange aproximadamente 2400 farmácias comunitárias em Portugal. O consumo foi estimado através da metodologia da Dose Diária Definida (DDD), sendo expresso em DDD por 1000 habitantes por dia (DHD), de acordo com a classificação “Anatómica, Terapêutica e Química” (ATC) da Organização Mundial da Saúde. A análise incluiu a estratificação por subclasse farmacoterapêutica, duração de ação e tipo de medicamento (genérico ou de marca). Observou-se uma diminuição global de aproximadamente 22% no consumo de benzodiazepinas ao longo do período em estudo. As benzodiazepinas ansiolíticas representaram a subclasse mais dispensada (cerca de 92% do total) ao longo de todo o período em análise, com valores de consumo substancialmente superiores aos das benzodiazepinas hipnóticas/sedativas (cerca de 7% do total) e das benzodiazepinas utilizadas como antiepiléticas (cerca de 1% do total). Em 2025, as cinco substâncias mais consumidas foram o alprazolam (DHD 27,0), lorazepam (DHD 22,7), o diazepam (DHD 10,6), o loflazepato de etilo (DHD 9,0) e o bromazepam (DHD 3,2). Todas apresentaram uma redução do consumo ao longo do período analisado, particularmente o diazepam (-29,3%) e o alprazolam (-23,4%). Em contraste com a tendência global observada, o consumo de clonazepam aumentou 158,3% entre 2013 e 2025, constituindo a principal exceção ao padrão de redução verificado nas restantes subclasses de benzodiazepinas. Os resultados evidenciam uma tendência global de redução no consumo de benzodiazepinas em Portugal, mantendo-se, contudo, o predomínio das benzodiazepinas ansiolíticas face às restantes subclasses, refletindo a elevada carga das perturbações de ansiedade na população portuguesa. Apesar da redução observada, o consumo de benzodiazepinas mantém-se expressivo, evidenciando a necessidade de políticas sustentadas de promoção da saúde mental, de educação terapêutica e de estratégias que promovam a utilização adequada e segura destes medicamentos.
Mental health currently constitutes one of the main public health challenges, assuming particular relevance in Portugal, which presents one of the highest prevalences of psychiatric disorders in Europe. Among these, anxiety disorders stand out due to their high frequency and impact on quality of life, being frequently associated with the use of benzodiazepines. In this context, monitoring the utilization patterns of these medications is essential to support rational prescribing strategies and health policies. The aim of this study was to evaluate the trends in benzodiazepine consumption in Portugal between 2013 and 2025, based on community pharmacy dispensing data. An observational, ecological, and retrospective study of the use of anxiolytic, sedative/hypnotic, and antiepileptic benzodiazepines was conducted using the Health Market Research® (HMR) database, which covers approximately 2,400 community pharmacies in Portugal. Consumption was estimated using the Defined Daily Dose (DDD) methodology and expressed in DDD per 1,000 inhabitants per day (DID), according to the World Health Organization's Anatomical Therapeutic Chemical (ATC) classification. The analysis included stratification by pharmacotherapeutic subclass, duration of action, and type of medication (generic or brand-name). An overall decrease of approximately 22% in benzodiazepine consumption was observed over the study period. Anxiolytic benzodiazepines represented the most frequently dispensed subclass (around 92% of the total) throughout the entire analyzed period, with consumption values substantially higher than those of hypnotic/sedative benzodiazepines (around 7% of the total) and benzodiazepines used as antiepileptics (around 1% of the total). In 2025, the five most consumed substances were alprazolam (DID 27.0), lorazepam (DID 22.7), diazepam (DID 10.6), ethyl loflazepate (DID 9.0), and bromazepam (DID 3.2). All of them showed a reduction in consumption over the analyzed period, particularly diazepam (-29.3%) and alprazolam (-23.4%). In contrast to the overall trend observed, clonazepam consumption increased by 158.3% between 2013 and 2025, constituting the main exception to the reduction pattern verified in the remaining benzodiazepine subclasses. The findings highlight an overall downward trend in benzodiazepine consumption in Portugal. However, the predominance of anxiolytic benzodiazepines over the other subclasses persists, reflecting the high burden of anxiety disorders in the Portuguese population. Despite the observed reduction, benzodiazepine consumption remains significant, emphasizing the need for sustained mental health promotion policies, therapeutic education, and strategies that promote the appropriate and safe use of these medications.
Mental health currently constitutes one of the main public health challenges, assuming particular relevance in Portugal, which presents one of the highest prevalences of psychiatric disorders in Europe. Among these, anxiety disorders stand out due to their high frequency and impact on quality of life, being frequently associated with the use of benzodiazepines. In this context, monitoring the utilization patterns of these medications is essential to support rational prescribing strategies and health policies. The aim of this study was to evaluate the trends in benzodiazepine consumption in Portugal between 2013 and 2025, based on community pharmacy dispensing data. An observational, ecological, and retrospective study of the use of anxiolytic, sedative/hypnotic, and antiepileptic benzodiazepines was conducted using the Health Market Research® (HMR) database, which covers approximately 2,400 community pharmacies in Portugal. Consumption was estimated using the Defined Daily Dose (DDD) methodology and expressed in DDD per 1,000 inhabitants per day (DID), according to the World Health Organization's Anatomical Therapeutic Chemical (ATC) classification. The analysis included stratification by pharmacotherapeutic subclass, duration of action, and type of medication (generic or brand-name). An overall decrease of approximately 22% in benzodiazepine consumption was observed over the study period. Anxiolytic benzodiazepines represented the most frequently dispensed subclass (around 92% of the total) throughout the entire analyzed period, with consumption values substantially higher than those of hypnotic/sedative benzodiazepines (around 7% of the total) and benzodiazepines used as antiepileptics (around 1% of the total). In 2025, the five most consumed substances were alprazolam (DID 27.0), lorazepam (DID 22.7), diazepam (DID 10.6), ethyl loflazepate (DID 9.0), and bromazepam (DID 3.2). All of them showed a reduction in consumption over the analyzed period, particularly diazepam (-29.3%) and alprazolam (-23.4%). In contrast to the overall trend observed, clonazepam consumption increased by 158.3% between 2013 and 2025, constituting the main exception to the reduction pattern verified in the remaining benzodiazepine subclasses. The findings highlight an overall downward trend in benzodiazepine consumption in Portugal. However, the predominance of anxiolytic benzodiazepines over the other subclasses persists, reflecting the high burden of anxiety disorders in the Portuguese population. Despite the observed reduction, benzodiazepine consumption remains significant, emphasizing the need for sustained mental health promotion policies, therapeutic education, and strategies that promote the appropriate and safe use of these medications.
Descrição
Palavras-chave
Benzodiazepinas Dispensa Prescrição Consumo Portugal Europa Benzodiazepines Dispensing Prescription Consumption Europe