Ten-year trend in prescriptions of z-hypnotics among the elderly: A nationwide, cross-sectional study in Taiwan

Background/PurposeThe objective of this study was to characterize the 10-year trend in prescriptions of z-hypnotics among the elderly in Taiwan, focusing on duration and dosages of the z-hypnotics prescribed. Data from the 2001–2010 Taiwan National Health Insurance Research Database (NHIRD) were used for this study.MethodsIncident users of hypnotics[z-hypnotics and benzodiazepine (BZD)], aged ≥65 years, for each fiscal year from 2001 to 2010 were identified from the Longitudinal Health Insurance Database 2000 and 2005 of NHIRD. The annual prevalence of z-hypnotic and BZD prescriptions was reported for each fiscal year during 2001–2010. Demographics of patients who received z-hypnotics and characteristics of their providers were described. Several measures, including prescription duration, daily pills, and daily dosage, were used to quantify the use of z-hypnotics in the elderly.ResultsDuring 2001–2010, the annual use of z-hypnotics per elderly patient was doubled: from 3.1 prescriptions in 2001 to 5.8 prescriptions of z-hypnotics annually in 2010. A similar pattern was observed in the annual use of BZD per elderly patient (3.2 prescriptions in 2001 to 5.5 prescriptions of BZD in 2010). The frequency of z-hypnotic prescriptions from medical centers decreased from 33.6% in the fiscal year 2001 to 19.7% in the fiscal year 2010. In recent years, most z-hypnotics were prescribed by clinics (38.6% in 2010) and by physicians not specializing in psychiatry. The frequency of zolpidem prescriptions was 66.6% in 2001, which increased to 86.7% in 2010. The most frequent prescription duration of z-hypnotics was 8–30 days, followed by 4–7 days and ≤3 days. Over 70–80% of the z-hypnotic prescriptions contained more than 1 weeks' supply of z-hypnotics.ConclusionOur empirical findings revealed a significant nationwide outpatient consumption of z-hypnotics in Taiwan. To our knowledge, our study was the first one to conduct an in-depth examination of patients' and providers' characteristics associated with z-hypnotics use among the elderly.