Soyombo, Stephanie, Stanbrook, Rhian, Aujla, Harpal, Capewell, David, Shantikumar, Mary, Kidy, Farah, Todkill, Daniel and Shantikumar, Saran (2019) Socioeconomic status and benzodiazepine and Z-drug prescribing : a cross-sectional study of practice-level data in England. Family Practice . doi:10.1093/fampra/cmz054 (In Press)

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Abstract

Background
Benzodiazepines and Z-drugs (such as zopiclone) are widely prescribed in primary care. Given their association with addiction and dependence, understanding where and for whom these medications are being prescribed is a necessary step in addressing potentially harmful prescribing.

Objective
To determine whether there is an association between primary care practice benzodiazepine and Z-drug prescribing and practice population socioeconomic status in England.

Methods
This was a cross-sectional study. An aggregated data set was created to include primary care prescribing data for 2017, practice age and sex profiles and practice Index of Multiple Deprivation (IMD) scores—a marker of socioeconomic status. Drug doses were converted to their milligram-equivalent of diazepam to allow comparison. Multiple linear regression was used to examine the association between IMD and prescribing (for all benzodiazepines and Z-drugs in total, and individually), adjusting for practice sex (% male) and older age (>65 years) distribution (%).

Results
Benzodiazepine and Z-drug prescribing overall was positively associated with practice-level IMD score, with more prescribing in practices with more underserved patients, after adjusting for age and sex (P < 0.001), although the strength of the association varied by individual drug. Overall, however, IMD score, age and sex only explained a small proportion of the overall variation in prescribing across GP practices.

Conclusion
Our findings may, in part, be a reflection of an underlying association between the indications for benzodiazepine and Z-drug prescribing and socioeconomic status. Further work is required to more accurately define the major contributors of prescribing variation.

Item Type:	Journal Article
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Family Practice
Publisher:	Oxford University Press
ISSN:	0263-2136
Official Date:	22 October 2019
Dates:	Date Event 22 October 2019 Available 26 August 2019 Accepted
Date of first compliant deposit:	28 August 2019
DOI:	10.1093/fampra/cmz054
Status:	Peer Reviewed
Publication Status:	In Press
Publisher Statement:	This is a pre-copyedited, author-produced version of an article accepted for publication in Family Practice following peer review. The version of record Stephanie Soyombo, Rhian Stanbrook, Harpal Aujla, David Capewell, Mary Shantikumar, Farah Kidy, Daniel Todkill, Saran Shantikumar, Socioeconomic status and benzodiazepine and Z-drug prescribing: a cross-sectional study of practice-level data in England, Family Practice, , cmz054, is available online at: https://doi.org/10.1093/fampra/cmz054.
Access rights to Published version:	Open Access
Description:	Free access as of 06/11/2019
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED [NIHR] National Institute for Health Research http://dx.doi.org/10.13039/501100000272
Related URLs:	Publisher

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