Doctor Shopping Behavior for Zolpidem Among Insomnia Patients in Taiwan: A Nationwide Population-Based Study

Sleep
Tzu-Hsuan LuYou-Meei Lin

Abstract

Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as ≥ 2 prescriptions by different doctors within ≥ 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic...Continue Reading

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Citations

Sep 9, 2017·Journal of the American Geriatrics Society·Hui-Ting ChengChung-Hsuen Wu
Apr 9, 2019·Journal of Market Access & Health Policy·Małgorzata BiernikiewiczMondher Toumi
Apr 22, 2020·PloS One·Shih-Chieh ShaoEdward Chia-Cheng Lai
May 15, 2020·Journal of Sleep Research·Hyunsoo KimNam Kyung Je
Aug 14, 2020·Journal of American College Health : J of ACH·Ya-Wen Hsu, Chun-Ping Chang
Sep 3, 2020·Healthcare·Clemens Scott KruseKaleigh Cormier

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