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

Ayumi Takano, Sachiko Ono, Hayato Yamana, Hiroki Matsui, Toshihiko Matsumoto, Hideo Yasunaga, Norito Kawakami

Research output: Contribution to journalArticle

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.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.

Original languageEnglish
Pages (from-to)e029641
JournalBMJ open
Volume9
Issue number7
DOIs
Publication statusPublished - 2019 Jul 26

Fingerprint

Health Insurance
Benzodiazepines
Prescriptions
Japan
Cohort Studies
Retrospective Studies
Databases
Drug Prescriptions
Drug Users
Pharmaceutical Preparations
Outpatients
Guidelines
Neurotic Disorders
Hypnotics and Sedatives
Mood Disorders
Ambulatory Surgical Procedures
Psychiatry
Half-Life
Logistic Models
Demography

Keywords

  • benzodiazepine
  • cohort study
  • dependence
  • long-term prescription
  • risk factors

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Factors associated with long-term prescription of benzodiazepine : a retrospective cohort study using a health insurance database in Japan. / Takano, Ayumi; Ono, Sachiko; Yamana, Hayato; Matsui, Hiroki; Matsumoto, Toshihiko; Yasunaga, Hideo; Kawakami, Norito.

In: BMJ open, Vol. 9, No. 7, 26.07.2019, p. e029641.

Research output: Contribution to journalArticle

Takano, Ayumi ; Ono, Sachiko ; Yamana, Hayato ; Matsui, Hiroki ; Matsumoto, Toshihiko ; Yasunaga, Hideo ; Kawakami, Norito. / Factors associated with long-term prescription of benzodiazepine : a retrospective cohort study using a health insurance database in Japan. In: BMJ open. 2019 ; Vol. 9, No. 7. pp. e029641.
@article{a43ea44caff647baa60e59da195445f3,
title = "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.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.",
keywords = "benzodiazepine, cohort study, dependence, long-term prescription, risk factors",
author = "Ayumi Takano and Sachiko Ono and Hayato Yamana and Hiroki Matsui and Toshihiko Matsumoto and Hideo Yasunaga and Norito Kawakami",
year = "2019",
month = "7",
day = "26",
doi = "10.1136/bmjopen-2019-029641",
language = "English",
volume = "9",
pages = "e029641",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "7",

}

TY - JOUR

T1 - Factors associated with long-term prescription of benzodiazepine

T2 - a retrospective cohort study using a health insurance database in Japan

AU - Takano, Ayumi

AU - Ono, Sachiko

AU - Yamana, Hayato

AU - Matsui, Hiroki

AU - Matsumoto, Toshihiko

AU - Yasunaga, Hideo

AU - Kawakami, Norito

PY - 2019/7/26

Y1 - 2019/7/26

N2 - 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.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.

AB - 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.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.

KW - benzodiazepine

KW - cohort study

KW - dependence

KW - long-term prescription

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=85070715448&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070715448&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2019-029641

DO - 10.1136/bmjopen-2019-029641

M3 - Article

C2 - 31350250

AN - SCOPUS:85070715448

VL - 9

SP - e029641

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 7

ER -