Komatsu Munehiro, Takeshima Masahiro, Yoshizawa Kazuhisa, Ogasawara Masaya, Kudo Mizuki, Miyakoshi Eru, Itoh Yu, Shibata Nana, Ayabe Naoko, Mishima Kazuo
Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Akita, Japan.
Department of Neuropsychiatry, Akita City Hospital, Akita, Akita, Japan.
Front Psychiatry. 2024 Dec 9;15:1471457. doi: 10.3389/fpsyt.2024.1471457. eCollection 2024.
Hypnotic polypharmacy and its long-term prescriptions constitute the inappropriate use of hypnotics. However, the relationship between hypnotic polypharmacy and prolonged prescriptions remains unclear. This study aimed to elucidate the association between hypnotic polypharmacy and the duration of hypnotic prescriptions.
This retrospective, cross-sectional study utilized a large dataset from the Japan Medical Data Center. The study population included adults who had been prescribed hypnotics between April 2020 and March 2021, with a focus on those receiving hypnotics in March 2021. Hypnotic polypharmacy was defined as the concurrent prescription of two or more hypnotics in March 2021. The duration of hypnotic prescriptions was measured by calculating the number of months between April 2019 and March 2021 during which hypnotics were prescribed. A binary logistic regression analysis was conducted to assess the relationship between hypnotic polypharmacy and long-term hypnotic prescriptions, adjusting for relevant covariates.
We included 112,256 patients (mean age: 49.5 years, females: 47.1%). Among them, 67.9% received hypnotic monotherapy, and 32.1% received hypnotic polypharmacy. Compared with adults who were prescribed hypnotics for 1 month, the association with polypharmacy was stronger in those who were prescribed hypnotics for ≥4 months as the duration of the prescription increased (adjusted odds ratio [aOR]: 1.15, 95% confidence interval [CI]: 1.04-1.27, p=0.006 for 4-6 months; aOR 1.35, 95% CI 1.23-1.49, p<0.001 for 7-9 months; aOR 1.58, 95% CI 1.43-1.73, p<0.001 for 10-12 months; and aOR 3.24, 95% CI 2.99-3.52 for 13-24 months).
This study demonstrated a significant association between hypnotic polypharmacy and long-term prescriptions of hypnotics. Initiating insomnia treatment with hypnotic monotherapy may reduce the likelihood of long-term prescriptions, and limiting the duration of hypnotic prescriptions could potentially prevent polypharmacy.
催眠药物联合使用及其长期处方构成了催眠药物的不当使用。然而，催眠药物联合使用与长期处方之间的关系仍不明确。本研究旨在阐明催眠药物联合使用与催眠药物处方时长之间的关联。
这项回顾性横断面研究使用了来自日本医学数据中心的大型数据集。研究人群包括在2020年4月至2021年3月期间开具过催眠药物处方的成年人，重点关注2021年3月接受催眠药物治疗的患者。催眠药物联合使用被定义为在2021年3月同时开具两种或更多种催眠药物。通过计算2019年4月至2021年3月期间开具催眠药物的月数来衡量催眠药物处方的时长。进行二元逻辑回归分析以评估催眠药物联合使用与长期催眠药物处方之间的关系，并对相关协变量进行调整。
我们纳入了112,256名患者（平均年龄：49.5岁，女性：47.1%）。其中，67.9%接受催眠药物单一疗法，32.1%接受催眠药物联合使用。与开具催眠药物1个月的成年人相比，随着处方时长增加，开具催眠药物≥4个月的成年人中联合用药的关联更强（调整后的优势比[aOR]：4至6个月为1.15，95%置信区间[CI]：1.04 - 1.27，p = 0.006；7至9个月为aOR 1.35，95% CI 1.23 - 1.49，p < 0.001；10至12个月为aOR 1.58，95% CI 1.43 - 1.73，p < 0.001；13至24个月为aOR 3.24，95% CI 2.99 - 3.52）。
本研究表明催眠药物联合使用与催眠药物长期处方之间存在显著关联。采用催眠药物单一疗法开始失眠治疗可能会降低长期处方的可能性，并且限制催眠药物处方的时长可能会潜在地预防联合用药。
