title: Demographic and clinical factors associated with benzodiazepine prescription at discharge from psychiatric inpatient treatment.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Benzodiazepines are frequently prescribed at discharge. Our results indicate strong racial and sex biases when prescribing benzodiazepines, even after controlling for diagnosis.
authors.affiliation: University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: shannon.peters001@umb.edu.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Peters
authors.affiliation: University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: kendra.knauf001@umb.edu.
authors.forename: Kendra Quincy
authors.initials: KQ
authors.lastname: Knauf
authors.affiliation: University of Utah, University Hospital, 50 North Medical Drive, 1R 052, Salt Lake City, UT 84132, USA. Electronic address: christina.derbidge@hsc.utah.edu.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Derbidge
authors.affiliation: University of Washington, 1959 Northeast Pacific Street, Box 356073, Seattle, WA 98195, USA. Electronic address: rjkimmel@u.washington.edu.
authors.forename: Ryan
authors.initials: R
authors.lastname: Kimmel
authors.affiliation: University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA. Electronic address: steven.vannoy@umb.edu.
authors.forename: Steven
authors.initials: S
authors.lastname: Vannoy
mesh_terms: D000328:Adult; D001007:Anxiety / Q000188:drug therapy; D001569:Benzodiazepines / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000188:drug therapy*; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D001569:Benzodiazepines
keywords: Benzodiazepine; Health disparities; Inpatient treatment; Prescribing