Sex differences among recipients of benzodiazepines in Dutch general practice

To analyse sex differences among recipients of benzodiazepines in Dutch general practice.

Study of consultations and associated interventions as recorded in the Dutch national survey of general practice.

Practices of 45 general practitioners monitored during 1 April to 30 June 1987.

61,249 patients (29,035 (47.4%) men in the age groups 19-44, 45-64, and 65 years and over.

Symptoms among recipients of repeat as well as new benzodiazepine prescriptions stratified by sex and age.

Prescriptions for benzodiazepines were found to be significantly more common among women than among men, (a) after correcting for the sex distribution of the total patient population, and (b) in the two oldest age groups after correcting for the number of consultations. Of all prescriptions for benzodiazepines, 89% (6055/6777) were repeats and 70% (4759/6777) requests. Only 9% (439/4759) of these were authorized by the general practitioner, the rest being issued by the general practitioner's assistant after he or she had referred to the diagnosis in the patient's record. In contrast, only three (1%) of the 492 first time recipients of benzodiazepines had requested a prescription and were not seen by the general practitioner. Women (43/96; 45%) aged 45-64 years received their first prescription for benzodiazepines almost twice as often as men (15/63; 24%) without symptoms or a diagnosis being an indication (female to male relative risk 1.88 (95% confidence interval 1.15 to 3.08)).

The sex difference among first time recipients of benzodiazepines seems to be due to general practitioners being less stringent when prescribing this drug for women. The difference continues in repeat prescriptions, physicians failing to check adequately the need for these.