Shannon M Peters1, Kendra Quincy Knauf2, Christina M Derbidge3, Ryan Kimmel4, Steven Vannoy5. 1. University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: shannon.peters001@umb.edu. 2. University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: kendra.knauf001@umb.edu. 3. University of Utah, University Hospital, 50 North Medical Drive, 1R 052, Salt Lake City, UT 84132, USA. Electronic address: christina.derbidge@hsc.utah.edu. 4. University of Washington, 1959 Northeast Pacific Street, Box 356073, Seattle, WA 98195, USA. Electronic address: rjkimmel@u.washington.edu. 5. University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: steven.vannoy@umb.edu.
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 [odds ratio (OR)=0.40]. Male sex (OR=0.56), Black race (OR=0.40) and age (OR=1.03) were nonclinical 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.
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 [odds ratio (OR)=0.40]. Male sex (OR=0.56), Black race (OR=0.40) and age (OR=1.03) were nonclinical 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.
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