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Trends in Insomnia Diagnosis and Treatment Among Medicare Beneficiaries, 2006-2013. | LitMetric

AI Article Synopsis

  • The study analyzed trends in insomnia diagnoses and treatment among Medicare beneficiaries over eight years, specifically from 2006 to 2013.
  • The prevalence of physician-assigned insomnia diagnoses rose from 3.9% to 6.2%, while the use of insomnia medications increased from 21.0% to 29.6%, with a significant spike in benzodiazepine use in 2013.
  • Overall, while diagnoses were low, medication use was much higher and remained stable, highlighting a notable increase in benzodiazepine prescriptions after their inclusion in the Medicare Part D formulary.

Article Abstract

Objective: 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.

Methods: This was a time-series analysis of Medicare administrative data for years 2006-2013. Insomnia was defined as the presence of at least one claim containing International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), code 307.41, 307.42, 307.49, 327.00, 327.01, 327.09, 780.52, or 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, nonbenzodiazepine 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.

Conclusion: 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387839PMC
http://dx.doi.org/10.1016/j.jagp.2018.10.017DOI Listing

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