Factors associated with high-quantity prescriptions of benzodiazepines in Sweden

An important aspect, when discussing the prescribing and use of psychotropics, is the amount of drug prescribed at each visit. In this study the Swedish Diagnosis and Therapy Survey was used in order to analyze high-quantity prescriptions of benzodiazepines. The total amount of benzodiazepines prescribed--measured as defined daily doses (DDD)--was calculated for each visit. Prescriptions with quantities equal to or greater than the 90th percentile applied on the distribution of prescribed DDD per visit were defined as high-quantity prescriptions. Using this definition, prescriptions on 200 DDD or more--14.9% of all--were classified as high-quantity prescriptions. In the analysis the proportions of high-quantity prescription in different subgroups were compared. The study showed that there was a strong relationship between age of the patient and high-quantity prescriptions while the sex of the patient was of minor importance. Doctors specializing in internal medicine and psychiatrists prescribed high-quantity prescriptions to a greater extent than other doctors but differences with regard to the doctor's ages were small. Patients with sleeping disturbances obtained high-quantity prescriptions to a greater extent than other patients while patients with nervous problems obtained fewer. Patients with new prescriptions on benzodiazepines obtained high-quantity prescriptions to a lesser extent than patients making repeat visits. In addition the study showed that it was not as common with high-quantity prescriptions in the three major cities and in the most sparsely populated communities as in mid-sized communities.