Eight-Year Follow-up of Hypnotic Delivery by Adults Aged 50 and Older from an Insurance Database.

STUDY

OBJECTIVES

This study sought to (1) identify patterns of hypnotic use among persons aged 50 and older for 8 years and (2) describe characteristics and correlates associated with them.

METHODS

A representative sample of national health insurance system beneficiaries was followed up from 2006 through 2013; individuals were grouped according to hypnotic delivery trajectories by latent class mixed models.

RESULTS

We identified four different temporal trajectories of hypnotic delivery among users. Delivery was occasional for 40% and regular for 60% (quasi-continuous "use": 27%; increasingly frequent over time: 17%; decreasingly frequent: 16%). Quasi-continuous "users" received hypnotics for more than 70% of the follow-up period and occasional "users" for less than 8%. We found no clear evidence of dose escalation. The three regular-delivery trajectories shared similar correlates (psychiatric disorders, somatic comorbidity, and coprescriptions of antidepressants or antipsychotics), but association with somatic comorbidity was highest by far for quasi-continuous "users."

CONCLUSIONS

Our results suggest that chronic hypnotic use covers different patterns resulting from different long-term temporal delivery trajectories. Because difficulties in stopping or reducing use may vary greatly according to these trajectories, patients may need individualized management approaches.