THU0464 USE OF BENZODIAZEPINES AND ANTIDEPRESSANTS IN PATIENTS WHO ATTEND A RHEUMATOLOGY CLINIC
Authors: M. P. Martínez-Vidal, A. Alvarez de Cienfuegos, V. Jovani, R. Martín-Domenech, M. T. Pedraz-Penalva, P. Bernabéu, J. R. Noguera-Pons
Journal: Annals of the Rheumatic Diseases (2020)

Background: During the last decades, anxiolytics and antidepressants (ADP) have been among the most prescribed therapies in all developed countries (1). In Spain a prevalence of use of 11.4% was communicated (2), slightly over the European average (3,4). They have potential addiction problems and side effects. Objectives: The objective of this study was to evaluate the prevalence of anxiolytics and antidepressants among patients who attend a Rheumatology consult, as well as the indication for them. Methods: Patients who were referred for the first time to the Rheumatology consult were included. Demographical data, reason for referral and final diagnosis were recorded. Regarding the treatment with ADP or/and benzodiazepines (BDZ), their duration and the indication for the prescription were recorded. Sample size was estimated for a 0.05% alpha risk. Descriptive, univariate and multivariate analyses (ANOVA) were performed in order to study the prevalence of these treatments, and their associations with demographical or clinical characteristics. The study was approved by the Hospital Universitario de Elche Ethics Committee. Results: 350 patients were included (women 77.1%, men 22.9%), mean age 58.1 yo. 40% were occupied and 31.4% were unemployed. The majority were married or lived with a couple (71.4%). Most of them had been referred for musculoskeletal pain (73.4%). More than a third (39.4%) were on BZD and/or ADP: 107 patients were on BZD (30.6%), 68 were on ADP (19.4%), and 47 (13.4%) were on both. The most frequent reasons for their prescription were anxiety, depression and insomnia. The final diagnosis in the clinic was a non-inflammatory condition in 53.1%, and inflammatory in 18%. In the univariate analyses, the use of BZD/ADP was not associated with civil status, but it was associated with female sex (p&lt;0.001), unemployment (p&lt;0.001) and non-inflammatory final diagnosis (p&lt;0.001). In the multivariate analyses, the use of BZD and/or ADP was associated with female sex (p=0.002 [RR 3.4, CI 95% 1.6-7.4]) and non-inflammatory final diagnosis, specifically fibromyalgia (p= 0.007 [RR 16.1, CI 95% 2.2-120.7]). Conclusion: The use of anxiolytics and antidepressants is frequent in the patients referred to the Rheumatology clinic, and it’s associated to female sex and non-inflammatory conditions, over all fibromyalgia. References: [1]Lagnaoui R, Depont F, Fourrier A, Abouelfath A, Bégaud B, Verdoux H, et al. Patterns and correlates of benzodiazepine use in the French general population. Eur J Clin Pharmacol. 2004;60:523-9. [2]Ministerio de Sanidad, Servicios Sociales e Igualdad. Secretaría de Estado de Servicios Sociales e Igualdad. Delegación del Gobierno para el Plan Nacional sobre Droga. Encuesta sobre alcohol y drogas en población general en España: EDADES 2011-2012. 2013. Disponible en: http://www.pnsd.msc.es/Categoria2/observa/pdf/EDADES2011.pdf [3]Simó Miñana J. Utilización de medicamentos en España y en Europa. Aten Primaria. 2012; 44:335-47. [4]Khong TP, de Vries F, Goldenberg JS, Klungel OH, Robinson NJ, Ibáñez L, Petri H. Potential impact of benzodiazepine use on the rate of hip fractures in five large European countries and the Unite d States Calcif Tissue Int. 2012;91:24-31. Disclosure of Interests: : None declared