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

IF 2.1 4区 医学 Q2 PSYCHOLOGY, CLINICAL Journal of psychoactive drugs Pub Date : 2024-04-01 Epub Date: 2023-03-20 DOI:10.1080/02791072.2023.2191610
Jeremy Weleff, Akhil Anand, Michael Squeri, Rachel Sieke, Nicolas R Thompson, Brian S Barnett
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Abstract

We sought to quantify benzodiazepine prescribing by primary care providers from 2019 to 2020 and identify correlates of prescribing. We hypothesized prescribing would increase post-COVID-19 lockdown. We conducted a retrospective cohort study of adult patients with primary care visits in 2019 or 2020 in a large Ohio healthcare system. Demographics, diagnosis codes, and receipt of benzodiazepine prescriptions were collected. Using multivariable logistic regression, we examined factors associated with benzodiazepine prescription receipt during the whole study period and post-lockdown. 455,537 adult patients had 1,643,473 visits. Benzodiazepines were prescribed in 3.2% (53,049/1,643,473) of visits. Effect sizes for positive associations with benzodiazepine prescription were largest for anxiety disorders. For negative associations, they were largest for Black patients and patients with cocaine use disorder. Benzodiazepine prescribing was positively associated with multiple groups having contraindications, though effect sizes were small. Contrary to our hypothesis, odds of receiving a prescription were 8.8% lower post-lockdown. Benzodiazepine prescribing rates in our system compared favorably to national rates. Year over year odds of receiving a prescription were slightly lower post-lockdown. Racial disparities were present and deserve further study. Strategies to reduce benzodiazepine prescribing to patients with anxiety may yield the largest reductions for benzodiazepine prescribing in primary care settings.

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2019-2020 年大型医疗保健系统初级保健患者苯二氮卓类药物处方分析。
我们试图量化 2019 年至 2020 年初级保健提供者开具的苯二氮杂卓处方,并确定处方的相关因素。我们假设,COVID-19 封锁后处方量会增加。我们对俄亥俄州大型医疗保健系统中 2019 年或 2020 年接受初级保健就诊的成年患者进行了一项回顾性队列研究。我们收集了人口统计数据、诊断代码以及苯二氮卓类药物处方的接收情况。通过多变量逻辑回归,我们研究了在整个研究期间和停诊后接受苯二氮卓处方的相关因素。455,537 名成年患者共就诊 1,643,473 次。3.2%的就诊者(53,049/1,643,473)开出了苯二氮杂卓处方。苯二氮卓类药物处方与焦虑症正相关的效应大小最大。就负相关而言,黑人患者和可卡因使用障碍患者的负相关最大。苯二氮卓类药物处方与多个有禁忌症的群体呈正相关,但效应量很小。与我们的假设相反,锁定后获得处方的几率降低了 8.8%。我们系统中苯二氮卓类药物的处方率与全国处方率相比毫不逊色。封锁后,获得处方的几率同比略有下降。种族差异是存在的,值得进一步研究。减少给焦虑症患者开苯二氮卓类药物处方的策略可能会最大程度地减少初级医疗机构的苯二氮卓类处方。
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来源期刊
CiteScore
5.30
自引率
7.10%
发文量
62
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