ArticleBMJ public health2026
Role of gender, age and rurality in benzodiazepine consumption in Catalonia, 2018-2022: a retrospective longitudinal drug utilisation study.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Benzodiazepines are among the most widely prescribed medications for numerous indications, but their adverse effects, misuse and consequences pose an increasing public health concern. This study analyses trends in benzodiazepine use in Catalonia from 2018 to 2022, focusing on differences by age, sex and rural-urban residence. Methods: A retrospective longitudinal drug utilisation study was conducted using the Information System for Research in Primary Care primary care database, including 6 992 261 individuals aged ≥15 years registered in Catalonia between 2018 and 2022. Drugs were classified according to the WHO's Anatomical Therapeutic Chemical system. Quantities dispensed were measured in defined daily doses (DDD) and expressed as DDD per 1000 inhabitants per day (DID) for each quarter. Data were stratified by age, sex and area of residence. Results: Benzodiazepine consumption increased across all demographic groups between 2018 and 2022. Key findings showed significant disparities by sex, age and urban-rural area, exacerbated by the intersection of these factors. Rural women over 65 showed the highest usage levels (428 DID in 2022), while young adults experienced the largest proportional increases with an estimated average quarterly percentage change of 4.06 (95% CI 4.02 to 4.09) in women and 3.20 (95% CI 3.15 to 3.23) among men. No statistically significant structural break was detected at the onset of the COVID-19 pandemic, suggesting that observed fluctuations reflected the underlying temporal trend. Conclusions: The consistent rise in benzodiazepine consumption across all age groups in Catalonia highlights gaps in prevention and management strategies. Disparities linked to socioeconomic factors, gender roles, older age and area of residence underscore structural inequities affecting older adults, women and rural populations. These findings reflect a deep-rooted public health challenge in Spain, driven by pharmacological over-reliance and insufficient attention to the impact caused by social determinants of health. Addressing this requires coordinated and multidisciplinary reforms to tackle inequity and enhance societal well-being.
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