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Trends in Insomnia Diagnosis and Treatment Among Medicare Beneficiaries, 2006–2013
- Source :
- The American Journal of Geriatric Psychiatry. 27:301-309
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- OBJECTIVES: Insomnia is an important clinical problem affecting the elderly. We examined trends in insomnia diagnosis and treatment among Medicare beneficiaries over an eight-year period. DESIGN: Time series SETTING AND PARTICIPANTS: 5% sample of Medicare administrative data for years 2006–2013 Measurements: Insomnia was defined as the presence of at least one claim containing International Classification of Disease, Version 9, Clinical Modification (ICD-9-CM) codes 307.41, 307.42, 307.49, 327.00, 327.01, 327.09, 780.52, V69.4 in any given year. Insomnia medications were identified by searching the Part D prescription drug files in each year for barbiturates, benzodiazepines, chloral hydrate, hydroxyzine, non-benzodiazepine sedative hypnotics, and sedating antidepressants. RESULTS: Prevalence of physician-assigned insomnia diagnoses increased from 3.9% in 2006 to 6.2% in 2013. Prevalence of any insomnia medication use ranged from 21.0% in 2006 to 29.6% in 2013 but remained steady. A sharp increase in use of benzodiazepines from 2012–2013 (1.1% to 17.6%) drove up total insomnia medication use for 2013. Prevalence of both insomnia diagnosis and medication use ranged from 3.5% in 2006 to 5.5% in 2013, while prevalence of either insomnia diagnosis or medication use ranged from 22.7% in 2006 to 31.0% in 2013. CONCLUSIONS: In this large national analysis of Medicare beneficiaries, prevalence of physician-assigned insomnia diagnoses was low but increased over time. Prevalence of insomnia medication use was up to four-times higher than insomnia diagnoses and remained steady over time. Notably, prevalence of benzodiazepine use increased dramatically from 2012–2013 after these medications were included in the Medicare Part D formulary.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Prescription drug
medicine.drug_class
Nonbenzodiazepine
Medicare
Article
Benzodiazepines
03 medical and health sciences
0302 clinical medicine
Sleep Initiation and Maintenance Disorders
mental disorders
Prevalence
Insomnia
Humans
Hypnotics and Sedatives
Medicine
Medicare Part D
Practice Patterns, Physicians'
Formulary
Aged
Aged, 80 and over
Hydroxyzine
Benzodiazepine
030214 geriatrics
business.industry
Antidepressive Agents
Drug Utilization
United States
Psychiatry and Mental health
Sedative
Female
Geriatrics and Gerontology
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 10647481
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- The American Journal of Geriatric Psychiatry
- Accession number :
- edsair.doi.dedup.....fd87063c6d65b478c76e7168c4fcdb19