Shahid Komel N, Hadlandsmyth Katherine, Brainerd Delaney R, Lund Brian C
Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.
VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, Iowa City, IA.
Am J Health Syst Pharm. 2025 Jan 24;82(3):e166-e172. doi: 10.1093/ajhp/zxae311.
While benzodiazepine prescribing among veterans with posttraumatic stress disorder (PTSD) declined substantially in the Veterans Health Administration over the past decade, little is known about current incident prescribing. Our objective was therefore to describe patient, provider, facility, and prescribing characteristics among veterans with PTSD who were incident benzodiazepine recipients in 2022 and contrast these to the characteristics for incident recipients in 2012.
This retrospective observational study included all veterans with PTSD who received an incident benzodiazepine prescription during calendar year 2022 and separately for 2012. The distribution of patient, provider, facility, and benzodiazepine prescribing characteristics was contrasted between years. Stratified subanalyses were conducted by potential non-PTSD benzodiazepine indication, including anxiety and sleep disorders.
A total of 28,310 (6.6%) incident benzodiazepine recipients were identified in 2012, which decreased to 16,776 (1.9%) incident recipients in 2022. The proportion of initial prescriptions written for a days' supply of 30 or more days decreased from 75.6% to 51.7%, and the proportion who received a second prescription within 6 months decreased from 68.7% to 53.5%. The proportion of patients with diagnoses for potential benzodiazepine indications also increased, including for generalized anxiety disorder (15.1% increase), obsessive compulsive disorders (0.6% increase), panic disorder (6.7% increase), and sleep disorders (22.9% increase).
As incident benzodiazepine prescribing among veterans with PTSD decreased over the past decade, so did the volume of drug dispensed and duration of therapy, while the prevalence of documented prescriptions for non-PTSD indications increased.
在过去十年中，退伍军人健康管理局内创伤后应激障碍（PTSD）退伍军人的苯二氮䓬类药物处方量大幅下降，但对于当前的新发处方情况知之甚少。因此，我们的目标是描述2022年新发接受苯二氮䓬类药物治疗的PTSD退伍军人的患者、提供者、医疗机构及处方特征，并将这些特征与2012年新发接受者的特征进行对比。
这项回顾性观察性研究纳入了2022日历年期间以及2012年单独接受新发苯二氮䓬类药物处方的所有PTSD退伍军人。对不同年份患者、提供者、医疗机构及苯二氮䓬类药物处方特征的分布情况进行对比。按潜在的非PTSD苯二氮䓬类药物适应症（包括焦虑症和睡眠障碍）进行分层亚分析。
2012年共识别出28310名（6.6%）新发接受苯二氮䓬类药物治疗的患者，到2022年这一数字降至16776名（1.9%）。开具30天及以上用量的初始处方比例从75.6%降至51.7%，在6个月内接受二次处方的比例从68.7%降至53.5%。诊断为潜在苯二氮䓬类药物适应症的患者比例也有所增加，包括广泛性焦虑症（增加15.1%）、强迫症（增加0.6%）、惊恐障碍（增加6.7%）和睡眠障碍（增加22.9%）。
在过去十年中，PTSD退伍军人的新发苯二氮䓬类药物处方量减少，配药量和治疗时长也随之减少，而记录在案的非PTSD适应症处方的患病率有所增加。
