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Pharmacoepidemiological characterization of psychotropic drugs consumption using a latent class analysis

Wainstein, Lauraa,c; Victorri-Vigneau, Carolinea,c; Sébille, Véroniqueb,c; Hardouin, Jean-Benoîtb,c; Feuillet, Fannyb,c; Pivette, Jacquesd; Chaslerie, Anicetd; Jolliet, Pascalea,c

International Clinical Psychopharmacology: January 2011 - Volume 26 - Issue 1 - p 54–62
doi: 10.1097/YIC.0b013e3283400cb2
Original Articles

France has one of the highest recorded rates of psychotropic use of drugs compared with other European countries, especially for anxiolytics, hypnotics and antidepressants. The aim of this study was to characterize the use of three psychotropic drugs among the most prescribed in France (bromazepam, paroxetine, zolpidem) using reimbursement databases in real-life conditions. Individuals from a region affiliated to the French General Health Insurance Scheme, who had received at least two dispensings of bromazepam, paroxetine or zolpidem reimbursed between 1 January and 30 June 2008, were included. We used a latent class analysis to identify different subgroups of users for these three psychotropic drugs. A total of 40 644 patients were included for bromazepam, 36 264 for zolpidem and 31 235 for paroxetine. Using latent class analysis, four clinical subtypes of users of bromazepam and zolpidem were identified: nonproblematic users, at-risk users, users with a probable mental disorder and compulsive users. Three subgroups were identified for paroxetine that differed rather by the prescription patterns. Users of anxiolytics and hypnotics with at-risk behaviours represented a significant proportion in the studied population. This original method could be extended to other prescription databases to identify populations at risk of abuse or dependence to psychotropic drugs.

aDepartment of Clinical Pharmacology, Center for Evaluation and Information on Pharmacodependence

bDepartment of Biostatistics, Nantes University Hospital

cEA 4275 Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Faculty of Pharmacy, Nantes University

dRegional Department of Health Insurance Medical Service of the Pays de la Loire, Nantes, France

Correspondence to Laura Wainstein, MD, Centre d'Evaluation et d'Information sur la Pharmacodépendance, Service de Pharmacologie Clinique, Institut de Biologie, 9 quai Moncousu, Nantes 44093 Cedex 1, France Tel: +33 240084073; fax: +33 240084097; e-mail: laura.wainstein@chu-nantes.fr

Received February 22, 2010

Accepted August 31, 2010

© 2011 Lippincott Williams & Wilkins, Inc.