High-dose and Long-term Users of Hypnotic and Sedative Drugs among Taiwanese Outpatients: Prevalence and Correlates from a Population-based Analysis

Aims: This study aims to analyze the dose and length of hypnotic and sedative drug prescriptions under a free-to-visit health insurance system. Study Design: Outpatients aged 15 years and older covered by the Taiwan National Health Insurance during 2007 (N=1,337,444) are included in this study. Methodology: The total amount of prescriptions for each patient was described according to the WHO Defined Daily Dosage (DDD) equivalent. Participants were categorized into 4 groups by dimensions of length (90 days) and dose (3 DDD per day). Patient characteristics and prescription drug use patterns were examined using a multinomial logit regression. Results: Although most prescription doses fell within the recommended ranges, the average flunitrazepam dose was substantially higher than that recommended for both long-term and high-dose users. Our results indicate that male sex, a psychiatric illness diagnosis, and receiving care at more than one institute were positively correlated with long-term use. However, these factors were negatively correlated with high-dose user. Distinct differences between the characteristics associated with long-term and high-dose use were observed, compared with normal users. Conclusion: These findings call for clinicians and policy makers to focus their attention on potential safety and efficiency issues. The alignment of prescribing practices and guidelines is highly recommended.