Dispensing Patterns of Anxiolytics and Sedative-Hypnotics: A Feasibility Study Comparing Datasets from a Developed and a Developing Country (Australia and South Africa)

Background: Dispensing patterns reflect drug usage trends. Benzodiazepines are known as drugs with potential for misuse, and frequent dispensing may be a surrogate marker of misuse. Objective: The primary aim of this study was to obtain a comparative snapshot of anxiolytic and sedative-hypnotic dispensing in a developing country and a developed country, to determine whether further research about benzodiazepines is warranted. Method: A cross-national, cross-sectional retrospective drug utilisation study was conducted on benzodiazepines and z-drugs. The South African database was obtained from a national medical insurance administrator and the Australian data were de-identified and extracted from pharmacies in the city of Brisbane in Queensland. Results: Diazepam was the most frequently dispensed anxiolytic in the Australian dataset (26.4%; n=1057/4010) while in the South African data, diazepam dispensing (17.2%; n=11597/67354) was superseded by alprazolam (17.8%; n=12009/67354) and followed by bromazepam (13.6%; n=9146/67354). The most frequently dispensed hypnotic in the South African data was zolpidem which accounted for 18.7% of records (n=12603/67354), while in the Australian data it was temazepam (24.9%; n=998/4010). Zolpidem was dispensed more frequently than zopiclone in both datasets. Conclusion: In South Africa there was relatively frequent use of alprazolam, bromazepam and zolpidem while in the Australian data diazepam, oxazepam and temazepam were most frequently dispensed. The use of alprazolam, identified as a drug of abuse in Australia, warrants further research in South Africa. The indicator described in this paper permitted a (qualitative) cross-sectional comparison of anxiolytics and sedative-hypnotics between a developed and a developing country (Australia and South Africa).