Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
J Psychoactive Drugs. 2024 Apr-Jun;56(2):245-256. doi: 10.1080/02791072.2023.2191610. Epub 2023 Mar 20.
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.
我们旨在量化 2019 年至 2020 年期间初级保健提供者开具苯二氮䓬类药物的情况，并确定开具此类药物的相关因素。我们假设在 COVID-19 封锁后开具此类药物的情况会增加。我们对一个大型俄亥俄州医疗保健系统中 2019 年或 2020 年有初级保健就诊的成年患者进行了回顾性队列研究。收集了人口统计学、诊断代码和苯二氮䓬类药物处方的情况。我们使用多变量逻辑回归分析，研究了整个研究期间和封锁后与开具苯二氮䓬类药物处方相关的因素。455537 名成年患者共进行了 1643473 次就诊。在 53049/1643473（3.2%）次就诊中开具了苯二氮䓬类药物。与开具苯二氮䓬类药物处方呈正相关的效应量最大的是焦虑障碍。对于负相关，最大的是黑人患者和可卡因使用障碍患者。苯二氮䓬类药物的开具与多个有禁忌症的群体呈正相关，尽管效应量较小。与我们的假设相反，封锁后开具处方的几率降低了 8.8%。我们系统中的苯二氮䓬类药物开具率与全国水平相比较为乐观。封锁后开具处方的年度几率略有降低。存在种族差异，值得进一步研究。减少焦虑症患者开具苯二氮䓬类药物的策略可能会使初级保健环境中苯二氮䓬类药物的开具量大幅减少。
