Zolpidem overutilisation among Korean patients with insomnia

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.