The influence of prescriber and patient gender on the prescription of benzodiazepines: evidence for stereotypes and biases?

• Published in: Social Psychiatry and Psychiatric Epidemiology 2021-06, Vol.56 (6), p.1083-1089
• Main Authors: McIntyre, Roger S., Chen, Vincent Chin-Hung, Lee, Yena, Lui, Leanna M. W., Majeed, Amna, Subramaniapillai, Mehala, Mansur, Rodrigo B., Rosenblat, Joshua D., Yang, Yao-Hsu, Chen, Yi-Lung
• Format: Article
• Language: English
• Subjects: Analysis; Anxiety; Benzodiazepines; Cohort analysis; Confidence intervals; Dosage; Drug dosages; Epidemiology; Gender; Halazepam; Human bias; Males; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; National health insurance; Online databases; Original Paper; Oxazepam; Patients; Population-based studies; Prescription writing; Psychiatrists; Psychiatry; Sex discrimination; Social aspects; Stereotypes
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-020-01989-4

Purpose Benzodiazepines are commonly prescribed globally. We hypothesize that gender stereotypes influence benzodiazepine prescriptions insofar as male prescribers are more likely to prescribe benzodiazepines to female patients. Methods Our nationwide cohort study included 2,127,441 patients with a psychiatric disorder (ICD-9 codes 290–319) and 38,932 prescribers as part of the Taiwan National Health Insurance Research Database (1997–2013). We evaluated the effects of patient and prescriber gender on the proportion of patients prescribed benzodiazepines and the cumulative dosage of benzodiazepine prescription (mg) using generalized estimating equation and general linear models. Results The proportion of patients prescribed benzodiazepines was higher among male (vs. female) prescribers [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.05–1.07] and among female (vs. male) patients (OR = 1.08, 95% CI = 1.08–1.09). Similarly, male prescriber gender ( β  = 10,292.2, SE = 1265.5, p