Zolpidem overutilisation among Korean patients with insomnia

Area of Science:

• Pharmacology
• Public Health
• Clinical Medicine

Background:

• Insomnia is a prevalent sleep disorder requiring effective treatment.
• Zolpidem is a commonly prescribed hypnotic agent for insomnia.
• Concerns exist regarding potential overutilisation and associated risks of zolpidem.

Purpose of the Study:

• To investigate the prevalence of zolpidem overutilisation in Korean patients with insomnia.
• To identify demographic and clinical factors associated with zolpidem overutilisation.

Main Methods:

• Analysis of the 2016 National Patient Sample (NPS) data from the Health Insurance Review & Assessment Service (HIRA-NPS).
• Definition of zolpidem overutilisation: use >30 consecutive days with prescription overlap >10%.
• Logistic regression model employed to identify risk predictors.

Main Results:

• An estimated 5.0% of patients exhibited zolpidem overutilisation.
• Risk factors included younger age (0-39 years), use of controlled-release formulations, and presence of psychiatric disorders (depression, bipolar disorder, schizophrenia, anxiety).
• Comorbid medical conditions such as hypertension, diabetes mellitus, and arthritis were also associated with overutilisation.

Conclusions:

• Zolpidem overutilisation is a notable issue in Korean insomnia patients.
• Targeted interventions are needed for high-risk groups, including younger patients and those with comorbidities.
• Strategies for prevention include promoting rational drug use, managing comorbidities, and implementing cognitive behavioural therapy for insomnia (CBT-I).