97
Views
1
CrossRef citations to date
0
Altmetric
Research Article

An Analysis of Benzodiazepine Prescribing to Primary Care Patients in a Large Healthcare System from 2019-2020

, DOORCID Icon, , MD, , MD, , MD, , MS & , MDORCID Icon
Pages 245-256 | Received 28 Sep 2022, Accepted 04 Mar 2023, Published online: 20 Mar 2023

References

  • Agarwal, S. D., and B. E. Landon. 2019. Patterns in outpatient benzodiazepine prescribing in the United States. JAMA Network Open 2 (1):e187399. doi:10.1001/jamanetworkopen.2018.7399.
  • Ashton, H. 1994a. Guidelines for the rational use of benzodiazepines. When and what to use. Drugs 48 (1):25–40. doi:10.2165/00003495-199448010-00004.
  • Ashton, H. 1994b. The treatment of benzodiazepine dependence. Addiction (Abingdon, England) 89 (11):1535–41. doi:10.1111/j.1360-0443.1994.tb03755.x.
  • Bartlett, G., M. Abrahamowicz, R. Tamblyn, R. Grad, R. Čapek, and R. du Berger. 2004. Longitudinal patterns of new benzodiazepine use in the elderly. Pharmacoepidemiology and Drug Safety 13 (10):669–82. doi:10.1002/PDS.908.
  • Blanco, C., B. Han, C. M. Jones, K. Johnson, and W. M. Compton. 2018. Prevalence and correlates of benzodiazepine use, misuse, and use disorders among adults in the United States. The Journal of Clinical Psychiatry 79:610.4088/JCP.18m12174
  • Burke, L. G., X. Zhou, K. L. Boyle, E. J. Orav, D. Bernson, M. E. Hood, T. Land, M. Bharel, and A. B. Frakt. 2020. Trends in opioid use disorder and overdose among opioid-naive individuals receiving an opioid prescription in Massachusetts from 2011 to 2014. Addiction (Abingdon, England) 115 (3):493–504. doi:10.1111/ADD.14867.
  • Cañada, Y., A. Sabater, P. Sierra, V. Balanzá-Martínez, M. Berk, S. Dodd, P. Navalón, L. Livianos, and A. García-Blanco. 2021. The effect of concomitant benzodiazepine use on neurocognition in stable, long-term patients with bipolar disorder. The Australian and New Zealand Journal of Psychiatry 55 (10):1005–16. doi:10.1177/0004867420969819.
  • Chen, H., P. Cohen, and S. Chen. 2010. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Communications in Statistics - Simulation and Computation 39 (4):860–64. doi:10.1080/03610911003650383.
  • Chung, K. H., C. Y. Li, S. Y. Kuo, T. Sithole, W. W. Liu, and M. H. Chung. 2015. Risk of psychiatric disorders in patients with chronic insomnia and sedative-hypnotic prescription: A nationwide population-based follow-up study. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine 11 (5):543–51. doi:10.5664/JCSM.4700.
  • Clark, R. E., H. Xie, and M. F. Brunette. 2004. Benzodiazepine prescription practices and substance abuse in persons with severe mental illness. The Journal of Clinical Psychiatry 65 (2):151–55. doi:10.4088/JCP.V65N0202.
  • Committee on the Review of Medicines. 1980. Systematic review of the benzodiazepines. Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. British Medical Journal 280 (6218):910–12. doi:10.1136/bmj.280.6218.910.
  • Cook, B., T. Creedon, Y. Wang, C. Lu, N. Carson, E. Lee, M. Alegría, and M. Alegría. 2018. Examining racial/ethnic differences in patterns of benzodiazepine prescription and misuse. Drug and Alcohol Dependence 187:29–34. doi:10.1016/j.drugalcdep.2018.02.011.
  • Cook, J. M., R. Marshall, C. Masci, and J. C. Coyne. 2007. Physicians’ perspectives on prescribing benzodiazepines for older adults: a qualitative study. Journal of General Internal Medicine 22 (3):303. doi:10.1007/S11606-006-0021-3.
  • Cook, B. L., Y. Wang, R. Sonik, S. Busch, N. Carson, A. M. Progovac, and A. M. Zaslavsky. 2019. Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning. Health Services Research 1 (Suppl 1):255–62. doi:10.1111/1475-6773.13104.
  • De Carlo, V., B. Grancini, M. Vismara, B. Benatti, C. Arici, L. Cremaschi, G. Cirnigliaro, L. Degoni, L. Oldani, C. Palazzo, et al. 2019. Exploring characteristics associated with first benzodiazepine prescription in patients with affective disorders and related diagnoses. Human Psychopharmacology 34 (3):e2695. doi: 10.1002/hup.2695.
  • de Dios, C., B. S. Fernandes, K. Whalen, S. Bandewar, R. Suchting, M. F. Weaver, and S. Selvaraj. 2021. Prescription fill patterns for benzodiazepine and opioid drugs during the COVID-19 pandemic in the United States. Drug and Alcohol Dependence 229:109176. doi:10.1016/j.drugalcdep.2021.109176.
  • de Gier, N. A. H., W. J. M. J. Gorgels, P. L. B. J. Lucassen, R. Oude Voshaar, J. Mulder, and F. Zitman. 2011. Discontinuation of long-term benzodiazepine use: 10-year follow-up. Family Practice 28 (3):253–59. doi:https://doi.org/10.1093/fampra/cmq113.
  • De Las Cuevas, C., E. Sanz, J. A. De La Fuente, C. Cabrera, and A. Mateos. 1999. Prescribed daily doses and ‘risk factors’ associated with the use of benzodiazepines in primary care. Pharmacoepidemiology and Drug Safety 8 (3):207–16. https://doi.org/10.1002/SICI1099-1557199905/068:3<207:AID-PDS421>3.0.CO;2-1.
  • Dollman, W. B., V. T. Leblanc, L. Stevens, P. J. O’connor, E. E. Roughead, and A. L. Gilbert. 2005. Achieving a sustained reduction in benzodiazepine use through implementation of an area-wide multi-strategic approach. Journal of Clinical Pharmacy and Therapeutics 30 (5):425–32. doi:10.1111/j.1365-2710.2005.00674.x.
  • Escrivá Ferrairó, R., A. Pérez Díez, C. Lumbreras García, J. Molina Paris, T. Sanz Cuesta, and M. A. Corral Sánchez. 2000. Benzodiazepine prescription at a health center: Prevalence, its use and user characteristics. Atencion Primaria 25 (2):107–10. doi:10.1016/S0212-6567(00)78472-1.
  • Esechie, A., Y. -F. Kuo, J. S. Goodwin, J. Westra, and M. A. Raji. 2021. Trends in prescribing pattern of opioid and benzodiazepine substitutes among Medicare part D beneficiaries from 2013 to 2018: A retrospective study. BMJ Open 11 (11):e053487. doi:10.1136/bmjopen-2021-053487.
  • Express Scripts. 2020. America’s State of Mind. U.S. trends in medication use for depression, anxiety and insomnia. Express Scripts. https://www.express-scripts.com/corporate/americas-state-of-mind-report.
  • Fontanella, C. A., J. V. Campo, G. S. Phillips, D. L. Hiance-Steelesmith, H. A. Sweeney, K. Tam, D. Lehrer, R. Klein, and M. Hurst. 2016. Benzodiazepine use and risk of mortality among patients with schizophrenia: A retrospective longitudinal study. The Journal of Clinical Psychiatry 77 (5):661–67. doi:10.4088/JCP.15m10271.
  • Foy, A., D. O’connell, D. Henry, J. Kelly, S. Cocking, and J. Halliday. 1995. Benzodiazepine use as a cause of cognitive impairment in elderly hospital inpatients. The Journals of Gerontology Series A, Biological Sciences and Medical Sciences 50 (2):M99–106. doi:10.1093/gerona/50a.2.m99.
  • Friedman, J., D. Kim, T. Schneberk, P. Bourgois, M. Shin, A. Celious, and D. L. Schriger. 2019. Assessment of Racial/Ethnic and Income Disparities in the Prescription of Opioids and Other Controlled Medications in California. JAMA Internal Medicine 179 (4):469–76. doi:10.1001/jamainternmed.2018.6721.
  • Gerlach, L. B., D. T. Maust, S. H. Leong, S. Mavandadi, and D. W. Oslin. 2018. Factors Associated with Long-term Benzodiazepine Use Among Older Adults. JAMA Internal Medicine 178 (11):1560–62. doi:10.1001/jamainternmed.2018.2413.
  • Guina, J., S. R. Rossetter, B. J. DeRhodes, R. W. Nahhas, and R. S. Welton. 2015. Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis. Journal of Psychiatric Practice 21 (4):281–303. doi:10.1097/PRA.0000000000000091.
  • Handal, M., S. Skurtveit, and J. G. Mørland. 2012. Co-medication with benzodiazepines. Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke 132 (5):526–30. doi:10.4045/TIDSSKR.11.0321.
  • Hawkins, E. J., S. B. Goldberg, C. A. Malte, and A. J. Saxon. 2019. New Coprescription of Opioids and Benzodiazepines and Mortality Among Veterans Affairs Patients with Posttraumatic Stress Disorder. The Journal of Clinical Psychiatry 80 (4). doi: 10.4088/JCP.18M12689.
  • Hawkins, E. J., C. A. Malte, H. J. Hagedorn, D. Berger, A. Frank, A. Lott, C. E. Achtmeyer, A. J. Mariano, and A. J. Saxon. 2017. Survey of Primary Care and Mental Health Prescribers' Perspectives on Reducing Opioid and Benzodiazepine Co-Prescribing Among Veterans. Pain Med 18 (3):454–67. doi:10.1093/pm/pnw140.
  • He, Q., X. Chen, T. Wu, L. Li, and X. Fei. 2019. Risk of Dementia in Long-Term Benzodiazepine Users: Evidence from a Meta-Analysis of Observational Studies. Journal of Clinical Neurology (Seoul, Korea) 15 (1):9–19. doi:10.3988/jcn.2019.15.1.9.
  • Hoertel, N., M. Sánchez-Rico, E. Gulbins, J. Kornhuber, R. Vernet, N. Beeker, and Initiative, >On behalf of A.-H./U./I. C.-19 research collaboration and A.-H. C. C. D. R. (2021). Association between benzodiazepine receptor agonist use and increased mortality among patients hospitalized for COVID-19: Results from an observational study. MedRxiv, 2021. 21252004. 10.1101/2021.02.18.21252004
  • Kaufmann, C. N., A. P. Spira, C. A. Depp, and R. Mojtabai. 2018. Long-term use of benzodiazepines and nonbenzodiazepine hypnotics, 1999-2014. Psychiatric Services (Washington, D.C.) 69 (2):235–38. doi:10.1176/APPI.PS.201700095.
  • Kirby, M., A. Denihan, I. Bruce, A. Radic, D. Coakley, and B. A. Lawlor. 1999. Benzodiazepine use among the elderly in the community. International Journal of Geriatric Psychiatry 14 (4):280–84. doi:10.1002/(SICI)1099-1166(199904)14:4<280:AID-GPS898>3.0.CO;2-O.
  • Kroll, D. S., H. R. Nieva, A. J. Barsky, and J. A. Linder. 2016. Benzodiazepines are prescribed more frequently to patients already at risk for benzodiazepine-related adverse events in primary care. Journal of General Internal Medicine 31 (9):1027–34. doi:https://doi.org/10.1007/s11606-016-3740-0.
  • Lader, M., A. Tylee, and J. Donoghue. 2009. Withdrawing benzodiazepines in primary care. CNS Drugs 23 (1):19–34. doi:10.2165/0023210-200923010-00002.
  • Lembke, A., J. Papac, and K. Humphreys. 2018. Our other prescription drug problem. The New England Journal of Medicine 378 (8):693–95. doi:10.1056/NEJMp1715050.
  • Lund, B. C., N. C. Bernardy, M. Vaughan-Sarrazin, B. Alexander, and M. J. Friedman. 2013. Patient and facility characteristics associated with benzodiazepine prescribing for veterans with PTSD. Psychiatric Services (Washington, D.C.) 64 (2):149–55. doi:10.1176/appi.ps.201200267.
  • Madhusoodanan, S., and O. J. Bogunovic. 2004. Safety of benzodiazepines in the geriatric population. Expert Opinion on Drug Safety 3 (5):485–93. doi:10.1517/14740338.3.5.485.
  • Marra, E. M., M. Mazer-Amirshahi, G. Brooks, J. van den Anker, L. May, and J. M. Pines. 2015. Benzodiazepine prescribing in older adults in u.s. ambulatory clinics and emergency departments (2001-10). Journal of the American Geriatrics Society 63 (10):2074–81. doi:10.1111/jgs.13666.
  • Maust, D. T., F. C. Blow, I. R. Wiechers, H. C. Kales, and S. C. Marcus. 2017. National trends in antidepressant, benzodiazepine, and other sedative-hypnotic treatment of older adults in psychiatric and primary care. The Journal of Clinical Psychiatry 78 (4):e363–71. doi:10.4088/JCP.16m10713.
  • Maust, D. T., H. M. Kim, I. R. Wiechers, R. V. Ignacio, A. S. B. Bohnert, and F. C. Blow. 2021. Benzodiazepine use among medicare, commercially insured, and veteran older adults, 2013–2017. Journal of the American Geriatrics Society 69 (1):98–105. doi:10.1111/jgs.16825.
  • Maust, D. T., L. A. Lin, and F. C. Blow. 2018. Benzodiazepine use and misuse among adults in the United States. Psychiatric Services 70 (2):97–106. doi:10.1176/appi.ps.201800321.
  • Mehrotra, A., M. E. Chernew, D. Linetsky, H. Hatch, and D. A. Cutler. 2020. The Impact of the COVID-19 pandemic on outpatient visits: a rebound emerges. https://www.commonwealthfund.org/publications/2020/apr/impact-covid-19-outpatient-visits.
  • Milani, S. A., M. A. Raji, L. Chen, and Y. -F. Kuo. 2021. Trends in the use of benzodiazepines, Z-Hypnotics, and serotonergic drugs among US women and men before and during the COVID-19 pandemic. JAMA Network Open 4 (10):e2131012. doi:10.1001/jamanetworkopen.2021.31012.
  • Morin, C. M., L. Bélanger, and F. Bernier. 2004. Correlates of benzodiazepine use in individuals with insomnia. Sleep Medicine 5 (5):457–62. doi:10.1016/J.SLEEP.2004.04.001.
  • Morin, C. M., B. Bjorvatn, F. Chung, B. Holzinger, M. Partinen, T. Penzel, H. Ivers, Y. K. Wing, N. Y. Chan, I. Merikanto, et al. 2021. Insomnia, anxiety, and depression during the COVID-19 pandemic: An international collaborative study. Sleep medicine 87 (Nov):38–45. doi:10.1016/j.sleep.2021.07.035.
  • Moro, R. N., A. I. Geller, N. J. Weidle, J. N. Lind, M. C. Lovegrove, K. O. Rose …, and D. S. Budnitz, J. K. McAninch, D. Dowell, D. S. Budnitz. 2020. Emergency department visits attributed to adverse events involving benzodiazepines, 2016–2017. American Journal of Preventive Medicine 58 (4):526–35. doi:10.1016/j.amepre.2019.11.017.
  • Mugunthan, K., T. McGuire, and P. Glasziou. 2011. Minimal interventions to decrease long-term use of benzodiazepines in primary care: A systematic review and meta-analysis. The British Journal of General Practice: The Journal of the Royal College of General Practitioners 61 (590):e573–8. doi:10.3399/bjgp11X593857.
  • National Institute on Drug Abuse. (2021). Overdose death rates. Retrieved July 30, 2021, from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
  • Nordfjærn, T., O. Bjerkeset, G. Bratberg, S. Moylan, M. Berk, and R. Gråwe. 2014. Socio-demographic, lifestyle and psychological predictors of benzodiazepine and z-hypnotic use patterns. Nordic Journal of Psychiatry 68 (2):107–16. doi:10.3109/08039488.2013.775342.
  • Olfson, M., M. King, and M. Schoenbaum. 2015. Benzodiazepine use in the United States. JAMA Psychiatry 72 (2):136–42. doi:10.1001/jamapsychiatry.2014.1763.
  • Palamar, J. J., B. H. Han, and S. S. Martins. 2019. Shifting characteristics of nonmedical prescription tranquilizer users in the United States, 2005-2014. Drug and Alcohol Dependence 195:1–5. doi:10.1016/j.drugalcdep.2018.11.015.
  • Perlis, R. H., M. J. Ostacher, D. J. Miklowitz, J. W. Smoller, E. B. Dennehy, C. Cowperthwait, A. A. Nierenberg, M. E. Thase, and G. S. Sachs. 2010. Benzodiazepine use and risk of recurrence in bipolar disorder: A STEP-BD report. The Journal of Clinical Psychiatry 71 (2):194–200. doi:10.4088/JCP.09m05019yel.
  • PsychCentral. (2019). Top 25 Psychiatric Medications for 2018. Retrieved June 8, 2022, from https://psychcentral.com/blog/top-25-psychiatric-medications-for-2018
  • Ribas Roca, J., T. Everett, D. Dongarwar, and H. M. Salihu. 2022. Racial-ethnic disparities in benzodiazepine prescriptions for anxiety in us emergency departments. Journal of Racial and Ethnic Health Disparities 10 (1):334–42. doi:10.1007/s40615-021-01224-z.
  • Rizvi, S. J., B. A. Sproule, L. Gallaugher, R. S. McIntyre, and S. H. Kennedy. 2015. Correlates of benzodiazepine use in major depressive disorder: The effect of anhedonia. Journal of Affective Disorders 187:101–05. doi:10.1016/J.JAD.2015.07.040.
  • Roache, J. D., and R. A. Meisch. 1995. Findings from self-administration research on the addiction potential of benzodiazepines. Psychiatric Annals 25 (3):153–57. doi:10.3928/0048-5713-19950301-08.
  • Rosenthal, R. N., M. R. Lofwall, S. Kim, M. Chen, K. L. Beebe, F. J. Vocci, and Grp, P.-814 S. 2016. Effect of buprenorphine implants on illicit opioid use among abstinent adults with opioid dependence treated with sublingual buprenorphine a randomized clinical trial. JAMA-JOURNAL of the AMERICAN MEDICAL ASSOCIATION 316 (3):282–90. doi:10.1001/jama.2016.9382.
  • Santabárbara, J., I. Lasheras, D. M. Lipnicki, J. Bueno-Notivol, M. Pérez-Moreno, R. López-Antón, C. De la Cámara, A. Lobo, and P. Gracia-García. 2021. Prevalence of anxiety in the COVID-19 pandemic: An updated meta-analysis of community-based studies. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 109:110207. doi:10.1016/j.pnpbp.2020.110207.
  • Seppala, L. J., W. Amat, M. de Vries, K. J. Ploegmakers, van de Glind Emm, J. G. Daams, and van der Velde N. 2018. EUGMS task and Finish group on fall-risk-increasing drugs. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. J Am Med Dir Assoc 19 (4):e371.11–17. doi:10.1016/j.jamda.2017.12.098.
  • Simon, G. E., and E. J. Ludman. 2006. Outcome of new benzodiazepine prescriptions to older adults in primary care. General Hospital Psychiatry 28 (5):374–78. doi:https://doi.org/10.1016/j.genhosppsych.2006.05.008.
  • Sorock, G. S., and E. E. Shimkin. 1988. Benzodiazepine sedatives and the risk of falling in a community-dwelling elderly cohort. Archives of Internal Medicine 148 (11):2441–44. doi:10.1001/archinte.1988.00380110083017.
  • Tanguay Bernard, M. M., M. Luc, J. D. Carrier, L. Fournier, A. Duhoux, E. Côté, O. Lessard, C. Gibeault, C. Bocti, and P. Roberge. 2018. Patterns of benzodiazepines use in primary care adults with anxiety disorders. Heliyon 4 (7):e00688. doi:10.1016/j.heliyon.2018.e00688.
  • Tannenbaum, C. 2015. Inappropriate benzodiazepine use in elderly patients and its reduction. Journal of Psychiatry & Neuroscience: JPN 40 (3):E27. doi:10.1503/JPN.140355.
  • Tori, M. E., M. R. Larochelle, and T. S. Naimi. 2020. Alcohol or benzodiazepine co-involvement with opioid overdose deaths in the United States, 1999-2017. JAMA Network Open 3 (4):e202361. doi:10.1001/jamanetworkopen.2020.2361.
  • Towle, I., and J. Adams. 2009. A novel, pharmacist-led strategy to reduce the prescribing of benzodiazepines in Paisley. The Pharmaceutical Journal. doi:10.1211/PJ.2009.10967534.
  • Voshaar, R. C., W. J. Gorgels, A. J. Mol, A. J. van Balkom, E. H. van de Lisdonk, M. H. Breteler, H. J. van den Hoogen, and F. G. Zitman. 2003. Tapering off long-term benzodiazepine use with or without group cognitive-behavioural therapy: Three-condition, randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science 182:498–504. doi: 10.1192/bjp.182.6.498.
  • Wu, C. S., Y. J. Lin, and S. K. Liu. 2011. Benzodiazepine use among patients with schizophrenia in Taiwan: A nationwide population-based survey. Psychiatric Services (Washington, D.C.) 62 (8):908–14. doi:10.1176/PS.62.8.PSS6208_0908.
  • Xu, K. Y., S. M. Hartz, J. T. Borodovsky, L. J. Bierut, and R. A. Grucza. 2020. Association between benzodiazepine use with or without opioid use and all-cause mortality in the United States, 1999-2015. JAMA Network Open 3 (12):e2028557. doi:10.1001/jamanetworkopen.2020.28557.
  • Zheng, D., J. Brett, B. Daniels, N. A. Buckley, S. A. Pearson, and A. L. Schaffer. 2020. Potentially inappropriate benzodiazepine use in Australian adults: A population-based study (2014-2017). Drug and Alcohol Review 39 (5):575–82. doi:10.1111/DAR.13086.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.