Demographic and clinical factors associated with benzodiazepine prescription at discharge from psychiatric inpatient treatment

Abstract

Objective We sought to characterize diagnostic and treatment factors associated with receiving a prescription for benzodiazepines at discharge from a psychiatric inpatient unit. We hypothesized that engaging in individual behavioral interventions while on the unit would decrease the likelihood of receiving a benzodiazepine prescription at discharge. Method This is an observational study utilizing medical chart review (n = 1007) over 37 months (2008–2011). Descriptive statistics characterized patient demographics and diagnostic/prescription frequency. Multivariate regression was used to assess factors associated with receiving a benzodiazepine prescription at discharge. Results The sample was 61% female with mean age = 40.5 (S.D. = 13.6). Most frequent diagnoses were depression (54.7%) and bipolar disorder (18.6%). Thirty eight percent of participants engaged in an individual behavioral intervention. Benzodiazepines were prescribed in 36% of discharges. Contrary to our hypothesis, individual behavioral interventions did not influence discharge benzodiazepine prescriptions. However, several other factors did, including having a substance use disorder (OR = 0.40). Male sex (OR = 0.56), Black race (OR = 0.40), and age (OR = 1.03) were non-clinical factors with strong prescribing influence. Conclusion Benzodiazepines are frequently prescribed at discharge. Our results indicate strong racial and sex biases when prescribing benzodiazepines, even after controlling for diagnosis.

A retrospective review on benzodiazepine use: A case study from a chronic dispensary unit

“…[10,[15][16][17] Epidemiological data suggest that females tend to have a higher prevalence of depression and anxiety than males, which are common therapeutic indications for BZDs. [2,22] This correlates with our finding that depression and depression and anxiety were the therapeutic conditions most often treated with a regimen that included a BZD. Additionally, studies suggest that females are more inclined to use medication and access health services than males, resulting in a greater likelihood of BZD use.…”

“…[2] The second most common therapeutic indication for BZD prescribing was depression. Studies in the USA have found depression to be the most common therapeutic indication for BZD prescription upon discharge, [13,22] while in developing countries such as Thailand and Lebanon depression has been identified as the third most common therapeutic indication. [19,26] These findings demonstrate the worldwide prevalence of BZD use in depression.…”

Exploring characteristics associated with first benzodiazepine prescription in patients with affective disorders and related diagnoses

“…In this respect, female patients were found to be more frequently BZD users in several reports. For instance, Peters and colleagues analyzed multiple demographic and clinical factors associated with BZD prescription at patients' discharge from psychiatric unit, reporting that women had a greater likelihood of receiving BZDs (Peters, Knauf, Derbidge, Kimmel, & Vannoy, ). Also Demyttenaere and colleagues, in the ESEMeD study, reported that, beyond specific clinical factors, female gender was more frequently associated with BZD use in the last year (Demyttenaere et al, ).…”

Misuse of benzodiazepines: Prevalence and impact in an inpatient population with psychiatric disorders

“…Patients with psychiatric disorders are particularly exposed to benzodiazepines and represent a very different population study than those usually considered when assessing the patterns of benzodiazepine use even when considering only older patients . Misuse of benzodiazepines might be more frequent when they are prescribed by a psychiatrist .…”

“…[6][7][8][9] Based on the National Institute for Health and Care Excellence guidelines, many countries recommend that benzodiazepine treatment should not exceed 4 consecutive weeks. [10][11][12] Patients with psychiatric disorders are particularly exposed to benzodiazepines 13,14 and represent a very different population study than those usually considered when assessing the patterns of benzodiazepine use even when considering only older patients. 15 Misuse of benzodiazepines might be more frequent when they are prescribed by a psychiatrist.…”