Characteristics of incident benzodiazepine recipients among US veterans with posttraumatic stress disorder

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. While benzodiazepine prescribing among veterans with posttraumatic stress disorder (PTSD) declined substantially in the Veterans Health Administration over the past decade, little is known about current incident prescribing. Our objective was therefore to describe patient, provider, facility, and prescribing characteristics among veterans with PTSD who were incident benzodiazepine recipients in 2022 and contrast these to the characteristics for incident recipients in 2012. This retrospective observational study included all veterans with PTSD who received an incident benzodiazepine prescription during calendar year 2022 and separately for 2012. The distribution of patient, provider, facility, and benzodiazepine prescribing characteristics was contrasted between years. Stratified subanalyses were conducted by potential non-PTSD benzodiazepine indication, including anxiety and sleep disorders. A total of 28,310 (6.6%) incident benzodiazepine recipients were identified in 2012, which decreased to 16,776 (1.9%) incident recipients in 2022. The proportion of initial prescriptions written for a days' supply of 30 or more days decreased from 75.6% to 51.7%, and the proportion who received a second prescription within 6 months decreased from 68.7% to 53.5%. The proportion of patients with diagnoses for potential benzodiazepine indications also increased, including for generalized anxiety disorder (15.1% increase), obsessive compulsive disorders (0.6% increase), panic disorder (6.7% increase), and sleep disorders (22.9% increase). As incident benzodiazepine prescribing among veterans with PTSD decreased over the past decade, so did the volume of drug dispensed and duration of therapy, while the prevalence of documented prescriptions for non-PTSD indications increased.