{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:36:12Z","timestamp":1788914172361,"version":"build-2803163510"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","funder":[{"name":"NIH","award":["1R01AG073410-01"],"award-info":[{"award-number":["1R01AG073410-01"]}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Benzodiazepines are commonly prescribed for post-acute ischemic stroke for anxiety, insomnia, and agitation. While guidelines discourage use in those aged \u226565 years, little is known about prescription patterns at the national level.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We analyzed a 20% sample of US Medicare claims from April 1, 2013, to September 30, 2021. We selected beneficiaries aged \u226565 years discharged alive following an acute ischemic stroke who had traditional Medicare coverage and 6 months\u2019 prior enrollment in Parts A (hospital insurance), B (Medical insurance), and D (drug coverage). We excluded those with prior benzodiazepine prescriptions, self-discharges, or discharge to skilled nursing facilities. We examined demographics, comorbidities, first prescription days\u2019 supply, cumulative incidences of benzodiazepine first prescription fills within 90 days after discharge, and geographic and yearly trends.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>We included 126\u2005050 beneficiaries with a mean age of 78 years (SD, 8); 54% were female and 82% were White. Within 90 days, 6127 (4.9%) initiated a benzodiazepine. Among new prescriptions, lorazepam (40%) and alprazolam (33%) were the most prescribed. Most (76%) of first fills had a day\u2019s supply over 7 days and 55% between 15 and 30 days. Female initiation rates were higher (5.5% [95% CI, 5.3\u20135.7]) than male initiation rates (3.8% [95% CI, 3.6%\u20133.9%]). Rates were highest in the southeast (5.1% [95% CI, 4.8%\u20135.3%]) and lowest in the midwest (4.0% [95% CI, 3.8%\u20134.3%]), with a modest nationwide initiation decline from 2013 to 2021 (cumulative incidence difference, 1.6%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Despite a gradual decline in benzodiazepine initiation from 2013 to 2021, we noted excessive supplies in prescriptions post-acute ischemic stroke discharge, underscoring the need for improved policies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.124.047257","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T09:02:35Z","timestamp":1729155755000},"page":"2694-2702","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Benzodiazepine Utilization in Ischemic Stroke Survivors: Analyzing Initial Excess Supply and Longitudinal Trends"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-6673","authenticated-orcid":true,"given":"Victor","family":"Lomachinsky Torres","sequence":"first","affiliation":[{"name":"Department of Neurology (V.L.T., J.D.B., M.A.D., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7624-2423","authenticated-orcid":true,"given":"Julianne D.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Neurology (V.L.T., J.D.B., M.A.D., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5217-7794","authenticated-orcid":true,"given":"Maria A.","family":"Donahue","sequence":"additional","affiliation":[{"name":"Department of Neurology (V.L.T., J.D.B., M.A.D., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-9388","authenticated-orcid":true,"given":"Shuo","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (S.S., S.H.), Harvard T.H. Chan School of Public Health, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8244-231X","authenticated-orcid":true,"given":"John","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy (J.H., J.P.N.), Harvard Medical School, Boston, MA."},{"name":"Department of Medicine (J.H.), Harvard Medical School, Boston, MA."},{"name":"Mongan Institute, Massachusetts General Hospital, Boston (J.H., M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Price","sequence":"additional","affiliation":[{"name":"Mongan Institute, Massachusetts General Hospital, Boston (J.H., M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6107-7376","authenticated-orcid":true,"given":"Deborah","family":"Blacker","sequence":"additional","affiliation":[{"name":"Department of Psychiatry (D.B.), Massachusetts General Hospital, Harvard Medical School, Boston."},{"name":"Department of Epidemiology (D.B.), Harvard T.H. Chan School of Public Health, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-9145","authenticated-orcid":true,"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, CT (L.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5837-3203","authenticated-orcid":true,"given":"Joseph P.","family":"Newhouse","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management (J.P.N.), Harvard T.H. Chan School of Public Health, Boston, MA."},{"name":"Department of Health Care Policy (J.H., J.P.N.), Harvard Medical School, Boston, MA."},{"name":"Harvard Kennedy School, Cambridge, MA (J.P.N.)."},{"name":"National Bureau of Economic Research, Cambridge, MA (J.P.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4963-0655","authenticated-orcid":true,"given":"Sebastien","family":"Haneuse","sequence":"additional","affiliation":[{"name":"Department of Biostatistics (S.S., S.H.), Harvard T.H. Chan School of Public Health, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1191-1315","authenticated-orcid":true,"given":"Lidia M.V.R.","family":"Moura","sequence":"additional","affiliation":[{"name":"Department of Neurology (V.L.T., J.D.B., M.A.D., L.M.V.R.M.), Massachusetts General Hospital, Harvard Medical School, Boston."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02971-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-71482-0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022720"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2013.02.009"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18372"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.02.033"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1763"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1129447"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.06.013"},{"key":"e_1_3_3_11_2","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA). 2019 NSDUH detailed tables | CBHSQ data. Accessed February 21 2024. https:\/\/www.samhsa.gov\/data\/report\/2019-nsduh-detailed-tables"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800321"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-016-0727-9"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000190"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2023.02.032"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-006-0021-3"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-007-0205-5"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053717"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.2051"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000113"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135834"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16825"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/106286069901400607"},{"key":"e_1_3_3_24_2","unstructured":"National Cancer Institute. SEER-Medicare: comorbidity SAS macros. Accessed February 13 2024. https:\/\/healthcaredelivery.cancer.gov\/seermedicare\/considerations\/calculation.html"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2015.1015961"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-018-0544-4"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-018-0542-4"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.105948"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2020.06.011"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010292"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-023-00777-y"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-068993"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S312037"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.27750"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1159\/000526165"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1686722"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12959"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.10413"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.00118"},{"key":"e_1_3_3_40_2","unstructured":"Department of Health and Human Services. Medicare beneficiary enrollment trends and demographic characteristics. ASPE. 2022. Accessed February 13 2024. https:\/\/aspe.hhs.gov\/reports\/medicare-enrollment"},{"key":"e_1_3_3_41_2","unstructured":"Centers for Medicare & Medicaid Services (CMS). Medicare part D charts. chronic conditions data warehouse. Accessed March 22 2024. https:\/\/www2.ccwdata.org\/medicare-charts\/medicare-part-d-charts"},{"key":"e_1_3_3_42_2","first-page":"27","article-title":"More accurate racial and ethnic codes for Medicare administrative data.","volume":"29","author":"Eicheldinger C","year":"2008","unstructured":"Eicheldinger C, Bonito A. More accurate racial and ethnic codes for Medicare administrative data. Health Care Financ Rev. 2008;29:27\u201342.","journal-title":"Health Care Financ Rev"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000914"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1159\/000521288"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17183"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmsa1807069"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.124.047257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T14:53:53Z","timestamp":1748530433000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.124.047257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1161\/STROKEAHA.124.047257"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.124.047257","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"2024-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}