[PND45] Prolonged-release melatonin: real-life evidence from a German longitudinal prescription database

[PND45] Prolonged-release melatonin: real-life evidence from a German longitudinal prescription database

2009 Value in health

Angermeyer, M.C. | Bineau, S. | Maman, K. | Toumi, M. | Milea, D. | Volume: 12, Issue: 7, Pages: A374, Melatonin, Longitudinal Studies, database analysis,

OBJECTIVES: Benzodiazepines and Z-drugs are extensively prescribed in patients
with insomnia, and their use raises public health concerns of dependence and increased
indirect costs (e.g., falls). The aim of this study was to investigate prescribing practice
patterns of Prolonged-Release Melatonin (PRM), a newly licensed hypnotic, in real-life
settings using longitudinal prescription database analyses. METHODS: Longitudinal
data of patients initiating PRM was extracted from a primary care prescription database
in Germany (IMS-DA). Patient characteristics (age, gender) and treatment information
(drug name, prescription date, number of packages and indication) were
retrieved. Descriptive analyses investigated the proportion of patients with or without
a past history of hypnotic use (defined as at least one benzodiazepine or Z-drug (BZDZ)
prescription within 3 months prior to PRM initiation). Descriptive statistics identi-
fied the proportion of patients with or without BZD-Z prescriptions within the 3
months following treatment initiation. Sensitivity analyses were performed on longer
follow-up periods (6 months) and higher numbers of previous BZD-Z prescriptions
(at least 2) to test the robustness of the findings. RESULTS: 1,382 eligible patient
records were retrieved. Two-thirds were female (mean age 62). Among them, 512
patients had a minimum 3-month history and 3-month follow-up. Approximately
80% were not prescribed BZD-Z before PRM initiation and of those, 90% were still
not prescribed any BZD-Z after 3 months. Among previous BZD-Z users, results
showed that approximately 1/3 (36/112) were not prescribed any BZD-Z medication
3 months after PRM initiation. Results were substantiated by sensitivity analyses on
both longer follow-up duration and a greater number of previous BZD-Z prescriptions.
CONCLUSIONS: PRM might represent an interesting alternative to BZD-Z use
for the treatment of insomnia. Further research with a larger study population is
needed to confirm these results.