College of Pharmacy, Pusan National University, Busan, Republic of Korea.
J Sleep Res. 2020 Aug;29(4):e13071. doi: 10.1111/jsr.13071. Epub 2020 May 14.
This study aimed to investigate zolpidem overutilisation among Korean patients with insomnia. We analysed the National Patient Sample (NPS) data compiled by the Health Insurance Review & Assessment Service (HIRA-NPS) in 2016. Zolpidem overutilisation was defined as when a patient used zolpidem for longer than 30 consecutive days and prescriptions overlapped with more than 10% of total prescription periods. Demographic and clinical factors associated with the overutilisation of zolpidem were investigated using a logistic regression model. The proportion of zolpidem overutilisers was estimated at 5.0%. Factors such as age (0-39 years), consuming controlled-release dosage formulations of zolpidem, presence of psychiatric disorders (depression, bipolar disorder, schizophrenia and anxiety disorder) and other medical conditions (hypertension, diabetes mellitus and arthritis) were observed to be risk predictors for zolpidem overutilisation. The formulation was selected owing to the absence of a quantity restriction for zolpidem CR in Korea during the study period. Possible approaches to prevention and control of zolpidem overutilisation include regulatory or legal provisions promoting rational drug use, management of psychiatric and medical co-morbid disorders, and widespread implementation of cognitive behavioural therapy for insomnia as a first-line treatment option.
本研究旨在调查韩国失眠症患者中佐匹克隆的过度使用情况。我们分析了 2016 年由健康保险审查与评估服务机构（HIRA-NPS）汇编的国家患者样本（NPS）数据。将患者使用佐匹克隆超过 30 天且处方重叠超过总处方期 10%的情况定义为佐匹克隆过度使用。使用逻辑回归模型调查了与佐匹克隆过度使用相关的人口统计学和临床因素。佐匹克隆过度使用者的比例估计为 5.0%。年龄（0-39 岁）、使用佐匹克隆控释剂型、存在精神障碍（抑郁症、双相情感障碍、精神分裂症和焦虑症）和其他医疗状况（高血压、糖尿病和关节炎）等因素被观察为佐匹克隆过度使用的风险预测因素。选择这种剂型是因为在研究期间，韩国没有对佐匹克隆 CR 进行数量限制。预防和控制佐匹克隆过度使用的可能方法包括促进合理用药的监管或法律规定、管理精神和医疗合并症、广泛实施认知行为疗法作为失眠的一线治疗选择。
