Factors associated with long-term prescription of benzodiazepine: a retrospective cohort study using a health insurance database in Japan.

ABSTRACT:

Objectives

Current clinical guidelines discourage long-term prescription of benzodiazepines and Z-drugs (BZD); however, the practice continues to exist. The aim of this study was to investigate the proportion of long-term BZD prescriptions and its risk factors.

Design

Retrospective cohort study using a health insurance database.

Setting

Japan.

Participants

A total of 86?909 patients were identified as outpatients aged 18 to 65 years who started BZD between 1 October 2012 and 1 April 2015. After excluding patients who underwent surgery on the day of first BZD prescription (n=762) and patients without 8?months follow-up (n=12?103), 74?044 outpatients were analysed.

Main outcome measures

We investigated the proportion of long-term prescriptions for ?8 months among new BZD users. We assessed patient demographics, diagnoses, characteristics of the initial BZD prescription and prescribers as potential predictors of the long-term BZD prescription. Multivariable logistic regression was performed to assess the association between long-term prescription and potential predictors.

Results

Of the new BZD users, 6687 (9.0%) were consecutively prescribed BZD for ?8 months. The long-term prescription was significantly associated with mood and neurotic disorder, cancer, prescription by psychiatrists, multiple prescriptions, hypnotics and medium half-life BZD in the initial prescription.

Conclusion

Despite the recent clinical guidelines, 9% of new BZD users were given prescriptions for more than 8 months. Physicians should be aware of risk factors when prescribing BZDs for the first time.

SUBMITTER: Takano A 

PROVIDER: S-EPMC6661576 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature