Trends in the prescription of drugs used for insomnia: an open-cohort study in Australian general practice, 2011-2018.
benzodiazepines
electronic health records
general practice
insomnia
sleep drug therapy
tranquilising agents
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
25
01
2021
accepted:
19
04
2021
pubmed:
6
5
2021
medline:
15
12
2021
entrez:
5
5
2021
Statut:
epublish
Résumé
Despite an increase in the prevalence of sleep problems, few studies have investigated changes in the prescribing of drugs that are often used to manage insomnia. To explore changes in the pattern of benzodiazepine (BZD), Z-drug (zolpidem, zopiclone), and non-BZD prescriptions. Open-cohort study comprising 1 773 525 patients (55 903 294 consultations) who attended one of 404 Australian general practices at least three times in two consecutive years between 2011 and 2018. Data were extracted from MedicineInsight, a database of 662 general practices in Australia. Prescription rates per 1000 consultations, the proportion of repeat prescriptions above recommendations, and the proportion of prescriptions for patients with a recent (within 2 years) recorded diagnosis of insomnia were analysed using adjusted regression models. Rates of BZD, Z-drug, and non-BZD prescriptions were 56.6, 4.4, and 15.5 per 1000 consultations in 2011 and 41.8, 3.5, and 21.5 per 1000 consultations in 2018, respectively. Over the whole study period, temazepam represented 25.3% of the prescriptions and diazepam 21.9%. All BZD and zolpidem prescriptions declined over the whole study period (annual change varying from -1.4% to -10.8%), but non-BZD and zopiclone prescriptions increased in the same period (annual change 5.0% to 22.6%). Repeat prescriptions that exceeded recommended levels remained at <10% for all medications, except melatonin (64.5%), zolpidem (63.3%), zopiclone (31.4%), and alprazolam (13.3%). In 2018, >50% of Z-drug and melatonin prescriptions were for patients with insomnia. There was an annual increase of 0.8-5.9% in the proportion of prescriptions associated with a recently recorded diagnosis of insomnia. Overall, BZD prescriptions in Australia declined between 2011 and 2018. However, the prescription of some of these drugs increased for patients with a recently recorded diagnosis of insomnia. This is concerning because of the potential adverse effects of these medications and the risk of dependence.
Sections du résumé
BACKGROUND
Despite an increase in the prevalence of sleep problems, few studies have investigated changes in the prescribing of drugs that are often used to manage insomnia.
AIM
To explore changes in the pattern of benzodiazepine (BZD), Z-drug (zolpidem, zopiclone), and non-BZD prescriptions.
DESIGN AND SETTING
Open-cohort study comprising 1 773 525 patients (55 903 294 consultations) who attended one of 404 Australian general practices at least three times in two consecutive years between 2011 and 2018.
METHOD
Data were extracted from MedicineInsight, a database of 662 general practices in Australia. Prescription rates per 1000 consultations, the proportion of repeat prescriptions above recommendations, and the proportion of prescriptions for patients with a recent (within 2 years) recorded diagnosis of insomnia were analysed using adjusted regression models.
RESULTS
Rates of BZD, Z-drug, and non-BZD prescriptions were 56.6, 4.4, and 15.5 per 1000 consultations in 2011 and 41.8, 3.5, and 21.5 per 1000 consultations in 2018, respectively. Over the whole study period, temazepam represented 25.3% of the prescriptions and diazepam 21.9%. All BZD and zolpidem prescriptions declined over the whole study period (annual change varying from -1.4% to -10.8%), but non-BZD and zopiclone prescriptions increased in the same period (annual change 5.0% to 22.6%). Repeat prescriptions that exceeded recommended levels remained at <10% for all medications, except melatonin (64.5%), zolpidem (63.3%), zopiclone (31.4%), and alprazolam (13.3%). In 2018, >50% of Z-drug and melatonin prescriptions were for patients with insomnia. There was an annual increase of 0.8-5.9% in the proportion of prescriptions associated with a recently recorded diagnosis of insomnia.
CONCLUSION
Overall, BZD prescriptions in Australia declined between 2011 and 2018. However, the prescription of some of these drugs increased for patients with a recently recorded diagnosis of insomnia. This is concerning because of the potential adverse effects of these medications and the risk of dependence.
Identifiants
pubmed: 33950853
pii: BJGP.2021.0054
doi: 10.3399/BJGP.2021.0054
pmc: PMC8366783
doi:
Substances chimiques
Hypnotics and Sedatives
0
Pharmaceutical Preparations
0
Benzodiazepines
12794-10-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e877-e886Informations de copyright
© The Authors.