Trends in benzodiazepine anxiolytics and z-hypnotics use among French drivers involved in road traffic crashes from 2005 to 2015: a responsibility case-control study.
Benzodiazepines
Pictogram
Road traffic crashes
Z-hypnotics
Journal
Injury epidemiology
ISSN: 2197-1714
Titre abrégé: Inj Epidemiol
Pays: England
ID NLM: 101652639
Informations de publication
Date de publication:
2019
2019
Historique:
received:
07
03
2019
accepted:
09
05
2019
entrez:
16
7
2019
pubmed:
16
7
2019
medline:
16
7
2019
Statut:
epublish
Résumé
In France, benzodiazepine anxiolytics and z-hypnotics (zolpidem and zopiclone) account for the largest share of road traffic crash risk attributable to exposure to prescription drugs. The aim of this study was to monitor the evolution of the use of these prescription drugs and their association with crash risk over a period that began before the implementation of a color-graded pictogram system printed on prescription drug boxes. Data from three French national databases were extracted and linked: the national health care insurance database, police reports, and the national police database of injurious crashes. Drivers involved in an injurious crash in France, from July 2005 to December 2015, and identified by their national identifier were included. The association with crash risk was estimated using a responsibility analysis comparing the use of benzodiazepines and z-hypnotics among drivers responsible or not for the crash. A total of 97,936 responsible and 103,522 non-responsible drivers involved in an injurious crash were included. The proportion of drivers exposed to benzodiazepine anxiolytics or z-hypnotics remained stable among responsible and non-responsible drivers. Among controls from the general population, the proportion of exposed individuals tended to increase. The association with crash risk remained almost constant over the study period. The odds-ratio for benzodiazepines ranged between 1.42 [1.24-1.62] at the beginning of the study period and 1.27 [1.09-1.47] at the end. Given the increase in exposure in the control group from the general population, the stability of exposure for responsible and non-responsible drivers can be interpreted as a relative effectiveness of the pictogram on driver exposure levels. On the other hand, while the intrinsic effect of a prescription drug cannot be modified, a decrease in risk could have been expected if drivers adapted their behavior as promoted by the pictogram. Our results therefore suggest that no significant change occurred in driving behaviors or consumption patterns.
Sections du résumé
BACKGROUND
BACKGROUND
In France, benzodiazepine anxiolytics and z-hypnotics (zolpidem and zopiclone) account for the largest share of road traffic crash risk attributable to exposure to prescription drugs. The aim of this study was to monitor the evolution of the use of these prescription drugs and their association with crash risk over a period that began before the implementation of a color-graded pictogram system printed on prescription drug boxes.
METHODS
METHODS
Data from three French national databases were extracted and linked: the national health care insurance database, police reports, and the national police database of injurious crashes. Drivers involved in an injurious crash in France, from July 2005 to December 2015, and identified by their national identifier were included. The association with crash risk was estimated using a responsibility analysis comparing the use of benzodiazepines and z-hypnotics among drivers responsible or not for the crash.
RESULTS
RESULTS
A total of 97,936 responsible and 103,522 non-responsible drivers involved in an injurious crash were included. The proportion of drivers exposed to benzodiazepine anxiolytics or z-hypnotics remained stable among responsible and non-responsible drivers. Among controls from the general population, the proportion of exposed individuals tended to increase. The association with crash risk remained almost constant over the study period. The odds-ratio for benzodiazepines ranged between 1.42 [1.24-1.62] at the beginning of the study period and 1.27 [1.09-1.47] at the end.
CONCLUSION
CONCLUSIONS
Given the increase in exposure in the control group from the general population, the stability of exposure for responsible and non-responsible drivers can be interpreted as a relative effectiveness of the pictogram on driver exposure levels. On the other hand, while the intrinsic effect of a prescription drug cannot be modified, a decrease in risk could have been expected if drivers adapted their behavior as promoted by the pictogram. Our results therefore suggest that no significant change occurred in driving behaviors or consumption patterns.
Identifiants
pubmed: 31304078
doi: 10.1186/s40621-019-0209-8
pii: 209
pmc: PMC6600897
doi:
Types de publication
Journal Article
Langues
eng
Pagination
32Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no conflicts of interest.
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