Trends in Outpatient Visits with Benzodiazepines among US Adults With and Without Bronchitis or Chronic Obstructive Pulmonary Disease from 1999 to 2010

Figures & data

Table 1. Number of unweighted and weighted office/outpatient department office visits among patients aged ≥40 years, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey

	1999	2000		2001		2002		2003		2004		2005		2006		2007		2008		2009		2010
Total visits
Unweighted numbers
NHAMCS-OPD	13,310	13,168		14,853		16,335		16,361		15,242		14,501		16,107		17,370		17,269		17,035		18,129
NAMCS	12,956	16,838		15,473		17,530		15,871		16,455		16,392		18,086		20,783		17,777		20,625		19,396
Weighted numbers
NHAMCS-OPD	39,614,000	41,131,000		40,777,000		39,281,000		43,444,000		41,063,000		43,122,000		52,209,000		45,813,000		56,763,000		50,295,000		53,015,000
NAMCS	449,325,000	476,216,000		528,670,000		525,055,000		543,250,000		555,645,000		595,812,000		539,832,000		599,586,000		594,969,000		655,892,000		614,543,000
Total	488,939,000	517,347,000		569,446,000		564,336,000		586,695,000		596,708,000		638,934,000		592,042,000		645,399,000		651,732,000		706,187,000		667,557,000
COPD visits
Unweighted numbers
NHAMCS-OPD	512	382		315		342		305		319		321		292		279		407		366		348
NAMCS	304	277		293		456		299		333		333		455		394		360		442		405
Weighted numbers
NHAMCS-OPD	1,362,000	1,123,000		1,020,000		1,134,000		1,206,000		1,106,000		1,424,000		1,379,000		1,182,000		1,860,000		1,294,000		1,201,000
NAMCS	14,783,000	11,867,000		17,199,000		21,358,000		15,279,000		16,395,000		19,411,000		18,686,000		14,983,000		15,110,000		19,132,000		18,478,000
Total	16,145,000	12,991,000		18,219,000		22,493,000		16,486,000		17,501,000		20,835,000		20,065,000		16,165,000		16,970,000		20,426,000		19,679,000
Non-COPD visits
Unweighted numbers
NHAMCS-OPD	12,798	12,786		14,538		15,993		16,056		14,923		14,180		15,815		17,091		16,862		16,669		17,781
NAMCS	12,652	16,561		15,180		17,074		15,572		16,122		16,059		17,631		20,389		17,417		20,183		18,991
Weighted numbers
NHAMCS-OPD	38,252,000	40,007,000		39,757,000		38,146,000		42,238,000		39,957,000		41,698,000		50,830,000		44,631,000		54,903,000		49,001,000		51,814,000
NAMCS	434,542,000	464,349,000		511,471,000		503,697,000		527,971,000		539,250,000		576,400,000		521,146,000		584,603,000		579,859,000		636,760,000		596,065,000
Total	472,794,000	504,356,000		551,228,000		541,843,000		570,209,000		579,207,000		618,099,000		571,976,000		629,234,000		634,763,000		685,761,000		647,879,000

COPD, chronic obstructive pulmonary disease; NAMCS, National Ambulatory Medical Care Survey; NHAMCS-OPD, National Hospital Ambulatory Medical Care Survey-Outpatient Department.

Figure 1. Average annual numbers of office/outpatient department office visits and patients with a mention of a benzodiazepine, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Results are shown for the numbers of visits made by patients with chronic obstructive pulmonary disease (Panel A), the numbers of visits made by patients without chronic obstructive pulmonary disease (Panel B), the numbers of patients with chronic obstructive pulmonary disease (Panel C), and the numbers of patients without chronic obstructive pulmonary disease (Panel D).

Table 2. Percentage of office/outpatient visits and patients with a mention of a benzodiazepine, by chronic obstructive pulmonary disease status, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey

	Visits				Patients
	1999-2002	2003-2006	2007-2010	P trend	2001-2002	2003-2006	2007-2010	P trend
Total
Total-unadjusted	4.3 (0.2)	4.8 (0.2)	6.4 (0.2)	<0.001	3.0 (0.2)	3.7 (0.2)	4.7 (0.2)	<0.001
Total-age-adjusted	4.3 (0.2)	5.0 (0.2)	6.7 (0.2)	<0.001	3.0 (0.2)	3.8 (0.2)	4.7 (0.2)	<0.001
Age (years)
40-49	4.6 (0.3)	5.5 (0.3)	7.5 (0.3)	<0.001	2.9 (0.3)	3.8 (0.2)	4.6 (0.3)	<0.001
50-59	4.6 (0.3)	5.5 (0.3)	6.9 (0.3)	<0.001	3.2 (0.3)	4.3 (0.3)	5.1 (0.4)	<0.001
60-69	4.0 (0.3)	4.4 (0.3)	6.1 (0.3)	<0.001	2.7 (0.3)	3.6 (0.3)	4.7 (0.4)	<0.001
≥70	3.9 (0.2)	4.0 (0.2)	5.5 (0.2)	<0.001	3.1 (0.3)	3.2 (0.2)	4.5 (0.3)	0.001
Gender
Women	4.8 (0.2)	5.6 (0.2)	7.6 (0.3)	<0.001	3.3 (0.2)	4.2 (0.2)	5.4 (0.3)	<0.001
Men	3.7 (0.2)	4.1 (0.2)	5.4 (0.2)	<0.001	2.5 (0.2)	3.1 (0.2)	3.8 (0.3)	<0.001
Race
White	4.5 (0.2)	5.4 (0.2)	7.1 (0.2)	<0.001	3.0 (0.2)	4.0 (0.2)	5.0 (0.3)	<0.001
Black	3.5 (0.5)	3.1 (0.3)	4.9 (0.3)	0.001	2.4 (0.5)	2.8 (0.4)	3.3 (0.4)	0.058
Other	3.2 (0.7)	1.9 (0.3)	3.7 (0.5)	0.341	—*	1.5 (0.3)	2.4 (0.4)	0.827
COPD visits
Total-unadjusted	4.6 (0.6)	6.8 (1.1)	10.2 (1.1)	<0.001	2.9 (0.6)	5.1 (0.9)	9.5 (1.5)	<0.001
Total-age-adjusted	3.9 (0.7)	6.8 (1.4)	9.9 (1.2)	<0.001	2.3 (0.5)	4.8 (1.0)	7.8 (1.3)	<0.001
Age (years)
40-49	—*	—*	9.8 (2.4)	0.034	—*	—*	—*	—
50-59	—*	—*	9.5 (1.8)	0.001	—*	—*	—*	—
60-69	4.1 (1.2)	6.8 (1.7)	9.7 (2.1)	0.021	—*	—*	9.9 (2.9)	0.009
≥70	5.9 (1.1)	5.2 (1.2)	11.0 (1.7)	0.014	4.7 (1.3)	4.0 (1.0)	12.7 (2.9)	0.012
Gender
Women	4.4 (1.1)	7.4 (1.7)	12.5 (1.7)	<0.001	—*	5.8 (1.5)	10.0 (2.0)	<0.001
Men	3.4 (0.7)	6.1 (1.6)	6.5 (1.3)	0.004	—*	3.6 (0.9)	—*	0.018
Race
White	3.9 (0.8)	7.4 (1.6)	10.5 (1.3)	<0.001	2.3 (0.6)	5.2 (1.1)	8.0 (1.3)	<0.001
Black	—*	—*	—*	—	—*	—*	—*	—
Other	—*	—*	—*	—	—*	—*	—*	—
No COPD visits
Total-unadjusted	4.2 (0.2)	4.7 (0.2)	6.3 (0.2)	<0.001	3.0 (0.2)	3.7 (0.2)	4.6 (0.2)	<0.001
Total-age-adjusted	4.3 (0.2)	4.9 (0.2)	6.6 (0.2)	<0.001	3.0 (0.2)	3.7 (0.2)	4.6 (0.2)	<0.001
Age (years)
40-49	4.6 (0.3)	5.5 (0.3)	7.4 (0.3)	<0.001	3.0 (0.3)	3.8 (0.2)	4.6 (0.3)	<0.001
50-59	4.6 (0.3)	5.4 (0.3)	6.9 (0.3)	<0.001	3.2 (0.3)	4.2 (0.3)	5.0 (0.4)	0.001
60-69	4.0 (0.3)	4.3 (0.3)	6.0 (0.3)	<0.001	2.7 (0.3)	3.6 (0.3)	4.6 (0.4)	<0.001
≥70	3.8 (0.2)	3.9 (0.2)	5.2 (0.2)	<0.001	3.0 (0.3)	3.1 (0.2)	4.2 (0.3)	0.002
Gender
Women	4.8 (0.2)	5.5 (0.2)	7.4 (0.3)	<0.001	3.3 (0.2)	4.1 (0.2)	5.2 (0.3)	<0.001
Men	3.7 (0.2)	4.1 (0.2)	5.3 (0.2)	<0.001	2.5 (0.2)	3.1 (0.2)	3.8 (0.3)	<0.001
Race
White	4.5 (0.2)	5.3 (0.2)	7.0 (0.2)	<0.001	3.0 (0.2)	4.0 (0.2)	5.0 (0.3)	<0.001
Black	3.4 (0.5)	3.1 (0.3)	4.8 (0.3)	0.002	2.4 (0.5)	2.8 (0.4)	3.3 (0.4)	0.075
Other	3.2 (0.7)	1.9 (0.3)	3.7 (0.5)	0.332	—*	1.5 (0.3)	2.5 (0.4)	0.828

COPD, chronic obstructive pulmonary disease.

*Estimates do not meet standards of precision or reliability (relative standard errors >30%).

Table 3. Adjusted* prevalence ratios (95% confidence interval) for office/outpatient department visits and patients with a mention of a benzodiazepine (yes/no), National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1999–2010

	Visits			Patients
Age (years)	Total	COPD	No COPD	Total	COPD	No COPD
40-49	1.00	1.00	1.00	1.00	1.00	1.00
50-59	0.97 (0.91, 1.04)	1.36 (0.85, 2.18)	0.96 (0.90, 1.03)	1.11 (1.00, 1.23)	2.06 (1.00, 4.24)	1.10 (0.99, 1.22)
60-69	0.83 (0.77, 0.89)	1.19 (0.74, 1.92)	0.82 (0.76, 0.89)	0.98 (0.88, 1.10)	2.16 (1.03, 4.53)	0.97 (0.86, 1.08)
≥70	0.74 (0.69, 0.80)	1.28 (0.82, 1.98)	0.73 (0.68, 0.79)	0.92 (0.83, 1.03)	2.58 (1.32, 5.07)	0.90 (0.81, 1.00)
Gender
Men	1.00	1.00	1.00	1.00	1.00	1.00
Women	1.42 (1.35, 1.50)	1.62 (1.25, 2.11)	1.41 (1.34, 1.49)	1.41 (1.29, 1.54)	2.19 (1.45, 3.29)	1.38 (1.27, 1.51)
Race
White	1.00	1.00	1.00	1.00	1.00	1.00
Black	0.69 (0.62, 0.76)	0.60 (0.35, 1.04)	0.69 (0.62, 0.77)	0.69 (0.59, 0.82)	0.56 (0.22, 1.39)	0.70 (0.59, 0.82)
Other	0.51 (0.42, 0.61)	0.17 (0.04, 0.71)	0.52 (0.43, 0.62)	0.57 (0.39, 0.83)	0.14 (0.03, 0.61)	0.58 (0.40, 0.84)
COPD status
Yes	1.48 (1.27, 1.71)	—	—	1.55 (1.25, 1.93)	—	—
No	1.00	—	—	1.00	—	—
Time period
1999-2002	1.00	1.00	1.00	1.00^†	1.00^†	1.00^†
2003-2006	1.13 (1.02, 1.26)	1.48 (0.96, 2.26)	1.12 (1.01, 1.24)	1.25 (1.08, 1.45)	1.67 (0.97, 2.89)	1.24 (1.06, 1.44)
2007-2010	1.53 (1.39, 1.68)	2.26 (1.60, 3.17)	1.51 (1.37, 1.66)	1.60 (1.37, 1.88)	3.21 (1.91, 5.39)	1.56 (1.33, 1.84)

COPD, chronic obstructive pulmonary disease.

*Adjusted for other variables shown in Table.

†Reference period is 2001–2002.

Figure 2. Unadjusted prevalence ratio (95% confidence interval) for office/outpatient department visits with a mention of a benzodiazepine (yes/no) among patients with chronic obstructive pulmonary disease aged ≥ 65 years, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey.