Benzodiazepine Prescribing Trends Amongst Elderly PTSD Veterans During the COVID-19 Pandemic

INTRODUCTION: Psychotropic medication prescribing amongst elderly veterans has increased over the course of the COVID-19 pandemic due to associated stressors. This is despite the fact that psychotropics such as benzodiazepines, when being prescribed for a period over 2 weeks, are considered as relatively contraindicated amongst such patients with an additional PTSD diagnosis due to a worsening of disease state symptoms. The study goal is to determine the extent of elderly PTSD veteran benzodiazepine prescribing for longer than a 2-week time period during 3 years of the COVID-19 pandemic compared to the 3 years prior to the COVID-19 pandemic. METHODS: A retrospective cohort of individuals with an age greater than or equal to 65 with a diagnosis of PTSD who were initiated a benzodiazepine prescription for longer than 2 weeks in the course of the before (January 1, 2016 through January 1, 2019) and during (January 1, 2019 through January 1, 2022) period of the COVID-19 pandemic was surveyed for comparison from amongst the veteran populations across the United States using the VINCI Corporate Data Warehouse. Exclusion criteria included those started on a benzodiazepine prescription from a source outside of the Veterans Health Administration (VHA) System. RESULTS: Out of 131,381 elderly patients presenting to the VHA System during the 3-year course prior to the COVID-19 pandemic, 24,832 individuals were initiated on a benzodiazepine for longer than 2 weeks despite having a history of PTSD. Of 123,231 elderly patients presenting to the VHA System during the 3-year course of the COVID-19 pandemic, 85,480 individuals were initiated on a benzodiazepine for longer than 2 weeks despite having a history of PTSD. The relative risk of such prescribing during the pandemic as compared to prior to the pandemic is 3.6. CONCLUSIONS: Benzodiazepine prescribing has increased substantially (3.6 times more likely chance of receiving such a medication for longer than 2 weeks) in the elderly veteran population despite having PTSD during the pandemic in comparison to prior to the pandemic. Further studies are needed to determine the true short- and long-term impacts of such prescribing practices upon this patient population. THIS RESEARCH WAS FUNDED BY: All study authors have nothing to disclose.