Prescriptions for drugs to treat anxiety, alcohol withdrawal and sleep problems are highest in the most deprived areas in England, according to a new study from the University of Warwick.
Benzodiazepines and Z-drugs are often prescribed as sedation, to treat people with anxiety or as sleeping tablets. They can be commonly prescribed but, according to guidelines should only be used for short periods of time to get a patient past an initial period of need.
A new study led by researchers from Warwick Medical School lin the journal Family Practice has analysed the rate of prescribing of these drugs in GP practices in England in 2017, and compared this to the estimated level of socioeconomic deprivation for each of these practices.
The study found a clear association between benzodiazepine and Z-drug prescribing in GP practices and socioeconomic deprivation, with more prescribing in practices that had patients from more deprived areas. This association persisted even after accounting for the age and sex demographic differences between GP practices’ patients.
The researchers used prescribing data from GP practices in England from NHS Digital for the year 2017 and compared this with practice-level Index of Multiple Deprivation scores from Public Health England and demographics for each practice from NHS Digital.
They found that the rate of prescribing of benzodiazepines and Z-drugs was on average 45 per cent higher in the most deprived GP practice populations compared to the least deprived (288 prescriptions per 1000 patients versus 198 prescriptions per 1000 patients in 2017).
The study’s lead author, Saran Shantikumar, said: “The key result we found was there was an association between the amount of benzodiazepines prescribed in GP practices and the level of deprivation of people served by that practice. However, this is a very broad association. What we can’t tell from our analysis is which people within a given practice are getting those prescriptions. In fact, a recent report from Public Health England suggested that, if anything, individual patients from the least deprived practices were more likely to be prescribed these drugs. So we’re left with a conundrum: if fewer patients from the most deprived practices are being prescribed benzodiazepines, why do they tend to be prescribed higher volumes of them?”
“One possibility is that the reasons for prescribing are systematically different between practices with high or low deprivation, and that those in more deprived practices are more likely to be given repeat prescriptions. Our finding that the relationship between deprivation and prescribing varied with different benzodiazepines lends some credence to that hypothesis.”