{"_buckets": {"deposit": "de964cd3-69e7-4fb1-9164-084025143b05"}, "_deposit": {"created_by": 15, "id": "5404", "owners": [15], "pid": {"revision_id": 0, "type": "depid", "value": "5404"}, "status": "published"}, "_oai": {"id": "oai:air.repo.nii.ac.jp:00005404", "sets": ["940"]}, "author_link": ["15095", "15097", "15096", "15094"], "item_10001_biblio_info_7": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2021-03-13", "bibliographicIssueDateType": "Issued"}, "bibliographic_titles": [{"bibliographic_title": "Drugs - Real World Outcomes"}]}]}, "item_10001_description_5": {"attribute_name": "内容記述（抄録）", "attribute_value_mlt": [{"subitem_description": "Background Prolonged treatment of insomnia using benzodiazepine (BZD) receptor agonists, including BZD and non-BZD hypnotic drugs, can cause drug dependence, tolerance, abuse and other adverse events. These side effects are more common and/or severe in older adults taking different hypnotic drugs concomitantly. Therefore, a single prescription is limited to 30 daily doses for most BZD receptor agonists and restrictions apply to the prescription of more than three types of hypnotic drugs in Japan. Little is known, however, about the real-world prescribing pattern of hypnotic drugs in Japan.  Objective We analysed prescribing patterns for hypnotic drugs in Japan to evaluate whether real-world use differs from guideline recommendations.  Methods In this nationwide, retrospective, longitudinal, observational study, we analysed the types of hypnotic drugs prescribed, duration of medication and treatment setting in a subset of hospitals in Japan using a hospital-based administrative claims database (Medical Data Vision). Patients initiating treatment with hypnotic drugs between January 2012 and December 2016 were included in the analyses to assess the duration of medication and occurrence of co-prescription of a second and third hypnotic drug, within a year from prescription of the first hypnotic drugs.  Results In 261,167 patients analysed, the first hypnotic drugs prescribed were BZDs (59.7%), non-BZDs (36.8%), a melatonin receptor agonist [MRA] (3.1%) and an orexin receptor antagonist [ORA] (0.4%). Benzodiazepine and non-BZD hypnotic drugs were mostly prescribed in inpatient settings (57.7% and 63.0%, respectively) and the MRA and ORA mostly in outpatient settings (62.6% and 65.4%, respectively). The departments that prescribed the most patients their first hypnotic drugs were internal medicine (23.6%), general surgery (11.8%), orthopaedic surgery (11.4%) and urology (5.3%). Of the total prescriptions of MRA and ORA as the first hypnotic drugs, 22.0% and 31.8% were in internal medicine, 4.4% each in general surgery, 6.0% and 4.5% in orthopaedic surgery, 9.7% and 4.4% in neurology, and 10.1% and 12.2% in psychiatry departments, respectively. Mean duration of medication was 1.13 months for non-BZDs, 1.15 months for BZDs, 1.29 months for the ORA and 1.83 months for the MRA. Overall, 5.3% (95% confidence interval 5.2–5.4) of patients were prescribed a second hypnotic drug; of these, 8.4% (95% confidence interval 8.0–8.9) were prescribed at least three hypnotic drugs within a year. Patients who were prescribed three or more hypnotic drugs received higher doses of the first drug than patients who received fewer hypnotic drugs.  Conclusions Benzodiazepine receptor agonists were the most common hypnotic drugs prescribed as the first drug to patients in Japan. Further education and awareness may be needed on the risk of complications and adverse events associated with these therapies. The duration of BZD receptor agonist use was shorter than for the MRA and ORA, in accordance with prescribing guidelines. Long-term use and co-prescribing of hypnotic drugs were also uncommon.  Key Points The side effects of prolonged benzodiazepine receptor agonist use are more common and/or severe in older adults who take multiple hypnotic drugs concomitantly. This study revealed that benzodiazepine receptor agonists are the most commonly prescribed first-line treatments and are mostly prescribed in the inpatient setting in hospital departments such as internal medicine, general surgery, orthopaedic surgery and urology. A melatonin receptor agonist and an orexin receptor antagonist were commonly prescribed to patients in an outpatient setting in internal medicine, psychiatry and neurology departments.", "subitem_description_type": "Other"}]}, "item_10001_publisher_8": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "Springer nature"}]}, "item_10001_relation_14": {"attribute_name": "DOI", "attribute_value_mlt": [{"subitem_relation_type": "isIdenticalTo", "subitem_relation_type_id": {"subitem_relation_type_id_text": "10.1007/s40801-021-00244-9", "subitem_relation_type_select": "DOI"}}]}, "item_10001_relation_25": {"attribute_name": "関連リンク", "attribute_value_mlt": [{"subitem_relation_type_id": {"subitem_relation_type_id_text": "https://doi.org/10.1007/s40801-021-00244-9", "subitem_relation_type_select": "DOI"}}]}, "item_10001_source_id_9": {"attribute_name": "ISSN", "attribute_value_mlt": [{"subitem_source_identifier": "2198-9788", "subitem_source_identifier_type": "ISSN"}]}, "item_10001_version_type_20": {"attribute_name": "著者版フラグ", "attribute_value_mlt": [{"subitem_version_resource": "http://purl.org/coar/version/c_970fb48d4fbd8a85", "subitem_version_type": "VoR"}]}, "item_creator": {"attribute_name": "著者", "attribute_type": "creator", "attribute_value_mlt": [{"creatorNames": [{"creatorName": "Inada, Ken"}], "nameIdentifiers": [{"nameIdentifier": "15094", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "Enomoto, Minori"}], "nameIdentifiers": [{"nameIdentifier": "15095", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "Yamato, Kentaro"}], "nameIdentifiers": [{"nameIdentifier": "15096", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "Mishima, Kazuo"}], "nameIdentifiers": [{"nameIdentifier": "15097", "nameIdentifierScheme": "WEKO"}]}]}, "item_files": {"attribute_name": "ファイル情報", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2021-06-04"}], "displaytype": "detail", "download_preview_message": "", "file_order": 0, "filename": "iA_2021_9.pdf", "filesize": [{"value": "1.1 MB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_free", "mimetype": "application/pdf", "size": 1100000.0, "url": {"label": "iA_2021_9", "url": "https://air.repo.nii.ac.jp/record/5404/files/iA_2021_9.pdf"}, "version_id": "22802129-46e4-4e77-a616-3d0d93cb14a0"}]}, "item_language": {"attribute_name": "言語", "attribute_value_mlt": [{"subitem_language": "eng"}]}, "item_resource_type": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"resourcetype": "journal article", "resourceuri": "http://purl.org/coar/resource_type/c_6501"}]}, "item_title": "Prescribing Pattern of Hypnotic Medications in Patients Initiating Treatment at Japanese Hospitals: A Nationwide, Retrospective, Longitudinal, Observational Study Using a Claims Database", "item_titles": {"attribute_name": "タイトル", "attribute_value_mlt": [{"subitem_title": "Prescribing Pattern of Hypnotic Medications in Patients Initiating Treatment at Japanese Hospitals: A Nationwide, Retrospective, Longitudinal, Observational Study Using a Claims Database"}]}, "item_type_id": "10001", "owner": "15", "path": ["940"], "permalink_uri": "http://hdl.handle.net/10295/00005726", "pubdate": {"attribute_name": "公開日", "attribute_value": "2021-06-04"}, "publish_date": "2021-06-04", "publish_status": "0", "recid": "5404", "relation": {}, "relation_version_is_last": true, "title": ["Prescribing Pattern of Hypnotic Medications in Patients Initiating Treatment at Japanese Hospitals: A Nationwide, Retrospective, Longitudinal, Observational Study Using a Claims Database"], "weko_shared_id": -1}