Current prescribing patterns and use of non-benzodiazepine hypnotics in a retail environment
Date
2009-02-25T13:31:04Z
Authors
Jain, Gauri
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Abstract
Abstract
Non-benzodiazepine drugs such as zopiclone and zolpidem are alternatives to treatment of
insomnia, but are recommended only for short-term treatment. The objectives of the study
were to evaluate the prescribing patterns and usage of these drugs.
Method: Data was collected from Clicks Rosebank Pharmacy. One hundred (100) patients
presenting with prescriptions for either zolpidem or zopiclone were followed over a period of
seven months and data was collected regarding: demographic characteristics of patients; drug
and dose distribution; ICD10 codes; prescriber characteristics; period of use; and whether
use was continuous or as needed (uninterrupted or interrupted). All data was collected from
the Unisolv computer system. Over a period of one year, total prescriptions received for all
drugs were compared to the total number of zopiclone/zolpidem prescriptions received to
gauge whether there was any seasonal variation in hypnotic use.
Results: In each age group, excluding 20 years and below, the number of females was greater
than males. The mean age of all patients between the ages of 21 and 80 years was 53.1 years.
Out of 100 patients, 85 (85%), used either zolpidem 10mg or zopiclone 7.5mg, which are the
standard doses. The most common ICD 10 code observed was G47.0, Disorders of initiating
and maintaining sleep [insomnias], occurring in 52 (52%) of 100 prescriptions. Of the 100
initial prescriptions, 68 (68%) were prescribed by General Practitioners, while 32 (32%) were
prescribed by Specialists. Thirty of the 100 patients (30%) used one of the drugs for the full
seven months; twenty two patients (22%) used one of the drugs for a period of one month or
less; and the remaining 48 patients (48%) used a hypnotic for a total of two to six months.
The number of patients who used a hypnotic in an interrupted manner, with each period of
use of one month or less duration, was 34 (34%). The number of patients who used a
hypnotic for at least one uninterrupted period of more than 1 month s duration was 66 (66%).
Over a period of 12 months, prescriptions for either zolpidem or zopiclone represented 3.17%
of total prescriptions. There was no significant seasonal fluctuation in hypnotic use.
Conclusion: The majority of patients used one of the two hypnotics in an uninterrupted
manner, and over a long term as well. Despite numerous cautions in the literature, these
medications are still being prescribed and used in a manner contrary to existing guidelines.
Description
Keywords
prescribing patterns, non-benzodiazepine hypnotics, pharmacies