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The prescription of benzodiazepines during office visits has increased over the past decade; New research shows that benzodiazepines are often co-prescribed with opioids and other sedative medications, often for conditions other than anxiety and insomnia.
Since benzodiazepines have been implicated in an increasing number of overdose-related deaths, this discovery is worrisome, investigators said. Medscape Medical News.
"The pendulum has begun to change when it comes to prescribing opioids, but we also have to be very careful about how we prescribe benzodiazepines.Benzodiazepines are easy to start but hard to stop," said the researcher. Study, Sumit Agarwal, Brigham and Women's Hospital in Boston, Mbadachusetts.
"I'm surprised we're not talking about this anymore, it's been called our" other "prescription drug problem," added Agarwal.
The study was published online on January 25 in JAMA Network open now.
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Agarwal and co-author Bruce Landon, MD, of Harvard Medical School, used nationally representative data to examine trends in prescribing benzodiazepines as outpatients. The badysis included more than 386,000 outpatient visits from 2003 to 2015.
Over the 13-year period, the benzodiazepine prescribing rate for ambulatory care visits in the United States almost doubled, from 3.8% in 2003 to 7.4% in 2015.
The benzodiazepine prescribing rate during visits to the psychiatrist remained stable during the study period (29.6% in 2003 and 30.2% in 2015), but increased among all other physicians. . This increase includes a doubling in the number of GP prescriptions, from 3.6% to 7.5%. As a group, PCP accounted for more than half of all benzodiazepine prescriptions (52.3%).
From 2003 to 2015, benzodiazepines were increasingly prescribed for anxiety and depression (from 26.6% to 33.5%), neurological conditions (from 6.8% to 8.7%) and back pain or chronic pain (3.6% to 8.5%).
The prescription of benzodiazepines with opioids quadrupled during the study period, from 0.5% in 2003 to 2.0% in 2015, while co-listing with other drugs sedated has doubled from 0.7% to 1.5%.
"What is most striking is not only that the use of benzodiazapines has increased in outpatient settings, but also that it is increasingly prescribed with opioids and other drugs. other sedative drugs, where the risks of adverse events are much more pronounced, "said Agarwal.
The authors note that there are "surprisingly few guidelines for a drug prescribed by as many different types of doctors and indications".
Benzodiazepines "may be effective drugs when they are used in patients appropriate for short-term use, but I am afraid we may experience chronic use, although there is no need for it. There is not much evidence in favor of its use for 8 or 10 weeks. "Patients, we should approach the idea of deprescribing with slow cones," said Agarwal.
The study did not have specific funding. Dr. Agarwal receives salary support from the Health Services and Resource Administration and the Ryoichi Sasakawa Scholarship Fund. No other relevant financial relationship has been disclosed.
JAMA Netw Open. Posted online 25 January 2019. Full text
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