Assessment of Benzodiazepines Dependence in Patients During Dispensing at Neighbourhood Pharmacies in Cote d’Ivoire
Objective: To identify the dispensing modes of benzodiazepines (BZD) and the level of dependence of patients to these drugs in the context of neighbourhood pharmacies. Methods: We carried out an observational study from December 2014 to August 2015 on the dispensing of BZD in 10 neighbourhood pharmacies selected randomly on the basis of one pharmacy in each district of Abidjan (Cote d’Ivoire). The survey was conducted with consenting patients whatever the mode of dispensing: medical prescription (MP), spontaneous demand (SD) or pharmaceutical council (PC). The Cognitive scale for benzodiazepine attachment (ECAB scale) was used with patients. An ECAB score ≥ 6 helps identify dependent patients. Results: A total of 298 patients were enrolled; dependence was assessed in 94.63% of them. The sex ratio was 1.5 males per female; the average age was 44.2 ± 14.2 years. Alcohol consumption was mentioned by 44.3% of patients. The dispensing of BZD was done by MP (61.4%), SD (34.9%) and PC (3.7%). The regulatory compliance of prescriptions was 54.6%. The most dispensed BZD were bromazepam (42.3%) and clonazepam (22.5%). A use of BZD ≥ 3 months concerned 40.6% of patients. An ECAB score ≥ 6 was found in 47.9% of patients. A duration of use of BZD>3 months was associated with a 25 times higher probability of being dependent (ECAB score ≥ 6). Conclusion: Pharmaceutical interventions should allow prevention, screening or management of BZD dependence. An optimal pharmaceutical follow-up must be exercised in neighbourhood pharmacies: an interview with the patient, the taking into account of the regulatory compliance of prescriptions, compliance with the rules for BZD delivery, respect of the limits of pharmaceutical medication with BZD, advice of respect of adherence and management of dependent patients.
Abrogoua DP, Vaubou F, Brou NA and Doffou E
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