Prescribing Z-drugs in Greece: an analysis of the national prescription database from 2018 to 2021

• Published in: BMC psychiatry Vol. 23; no. 1; p. 370
• Main Authors: Siafis, Spyridon, Fountoulakis, Konstantinos N, Fragkidis, Vasileios, Papazisis, Georgios
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 26.05.2023; BioMed Central; BMC
• Subjects: Age groups; Aged; Antidepressants; Antidepressive Agents; Anxiolytics; Benzodiazepines; Care and treatment; Comorbidity; Computerized physician order entry; COVID-19; Data analysis; Datasets; Diagnosis; Drug abuse; Drug Prescriptions; Drug stores; Drug therapy; Family physicians; Female; Females; Greece; Greece - epidemiology; Humans; Hypnotics and Sedatives; Insomnia; Male; Methods; Narcotics; Pandemics; Patients; Pharmacoepidemiology; Pharmacy; Prescription drugs; Prescription writing; Psychiatrists; Psychiatry; Psychotropic drugs; Sleep disorders; Sleep Initiation and Maintenance Disorders; Trends; Z-drugs; Zolpidem; Zolpidem - therapeutic use; Zopiclone; Greece; Greece; Pharmacoepidemiology; Zolpidem; Sleep disorders; Z-drugs; Zopiclone
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-023-04793-x

The Z-drugs are indicated for the short-treatment of insomnia, but they are associated with abuse, dependence and side-effects. There are only sparse data about Z-drug prescribing in Greece. We analyzed data from the Greek prescription database, considering prescriptions for the available Z-drugs in Greece, i.e., zolpidem and zopiclone, during the period from 01.10.2018 to 01.10.2021 in order to examine the prevalence, monthly number and characteristics of Z-drug prescriptions in Greece. There were 1,229,842 prescriptions for Z-drugs (zolpidem: 89.7%) during the investigated period from 2018 to 2021, which corresponded to 156,554 patients (73.1% ≥ 65 years, 64.5% female). More than half of the patients (65.8%) had more than one prescription with a median number of 8, interquartile range IQR [3, 17], prescriptions during the three-year study period. Most patients (76.1%) were prescribed by medical specialties other than psychiatrists and neurologists, despite a considerable frequency of psychiatric comorbidities (53.7%). About half of patients with anxiety/depression were not prescribed anxiolytics or antidepressants, a practice more frequently observed among medical specialties other than psychiatrists and neurologists. The average annual prevalence of at least one prescription for Z-drugs in the Greek population during 2019-2020 was approximately 0.9% (higher in females and older adults). The monthly number of prescriptions was relatively stable with a median number of 334.2 IQR [310.4; 351.6] prescriptions per 100,000 persons. A considerable number of patients are prescribed Z-drugs in Greece, more often older adults, females and patients with psychiatric comorbidities. The prescribing physicians were in the majority (70%) internists and general practitioners, while psychiatrists (10.9%) and neurologists (6.1%) accounted for a smaller proportion. Due to the limitations inherent to medical claims databases, further research is warranted in order to elucidate the potential abuse and misuse of Z-drugs.