Prescription Benzodiazepine Use in Privately Insured U.S. Children and Adolescents.
Administrative Claims, Healthcare
/ statistics & numerical data
Adolescent
Adolescent Health
Anxiety Disorders
/ drug therapy
Benzodiazepines
/ economics
Central Nervous System Depressants
/ economics
Child
Child Health
Child, Preschool
Databases, Factual
/ statistics & numerical data
Drug Prescriptions
/ economics
Drug Utilization
/ economics
Female
For-Profit Insurance Plans
/ economics
Humans
Male
Mental Health
Risk Assessment
Time Factors
Journal
American journal of preventive medicine
ISSN: 1873-2607
Titre abrégé: Am J Prev Med
Pays: Netherlands
ID NLM: 8704773
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
06
02
2019
revised:
14
07
2019
accepted:
15
07
2019
entrez:
23
11
2019
pubmed:
23
11
2019
medline:
1
9
2020
Statut:
ppublish
Résumé
Benzodiazepines are commonly prescribed in the U.S. but entail safety concerns, including dependency. In pediatrics, many indications lack trial data. Authors aimed to describe youth initiating prescription benzodiazepine treatment, identify potential indications and prescribing concerns, estimate the duration of treatment by potential indication, and identify factors that predict long-term use. The study cohort included children (aged 3-12 years) and adolescents (aged 13-17 years) initiating prescription benzodiazepine treatment (≥3 days' supply) from January 2010 to September 2015 in a U.S. commercial claims database. Potential indications included selected ICD-9-CM diagnoses (≤30 days prior). Long-term (≥6 months) benzodiazepine treatment was estimated with Kaplan-Meier estimation and modified Poisson regression identified independent predictors of long-term benzodiazepine treatment (analysis completed in 2018). Of 24,504 children and 61,046 adolescents initiating benzodiazepines, 62% of the children and 68% of the adolescents had a potential indication. Anxiety disorders were the most common indication, with mental health indications more common among adolescents (45%) than children (23%) and epilepsy and movement disorders higher in children. Recent opioid prescriptions were common before benzodiazepine initiation (children, 22%; adolescents, 21%). Six percent of the initiators became long-term benzodiazepine users. Potential indication, provider contact, psychotropic medication, and chronic conditions independently predicted long-term benzodiazepine treatment in adolescents and children. U.S. children and adolescents are prescribed benzodiazepines for various mental health and other medical conditions, many lacking evidence of pediatric efficacy. Long-term benzodiazepine treatment, concurrent opioid prescriptions, psychotropic use, and prior substance use disorder diagnoses suggest safety risks among some youth prescribed benzodiazepines.
Identifiants
pubmed: 31753258
pii: S0749-3797(19)30312-5
doi: 10.1016/j.amepre.2019.07.006
pmc: PMC6935869
mid: NIHMS1543947
pii:
doi:
Substances chimiques
Central Nervous System Depressants
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
775-785Subventions
Organisme : AHRQ HHS
ID : U19 HS021112
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH013043
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023258
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA047347
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS026001
Pays : United States
Informations de copyright
Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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