The influence of co-morbidities on prescribing pharmacotherapy for insomnia: evidence from US national outpatient data 1995-2004.
OBJECTIVE
Patients with insomnia are likely to have other co-morbidities that could affect pharmacotherapeutic choices. This study examined the prevalence and impact of co-morbidities on the pharmacological treatment of insomnia.


METHODS
A retrospective data analysis of the National Ambulatory Medical Care Survey from 1995 to 2004, comprising patients with a diagnosis of insomnia, was conducted. Multivariate logistic regression models were used to predict the impact of co-morbidities on pharmacotherapy for insomnia.


RESULTS
A total of 5,487 unweighted patient visits with insomnia were identified, representing 161.4 million patients in the US. Approximately 38% of these patients had at least one co-morbid condition. Patients with mental co-morbidities, especially anxiety, had decreased likelihood of receiving pharmacotherapy for insomnia.


CONCLUSIONS
Mental co-morbidities such as episodic mood disorder, anxiety and depression are prevalent in patients with insomnia. However, many co-morbid patients do not receive pharmacological therapy specific for insomnia.
Pawaskar
Manjiri D
MD
Department of Pharmacy Practice and Administration, Ohio State University College of Pharmacy, Columbus, OH, USA.
Joish
Vijay N
VN
Camacho
Fabian T
FT
Rasu
Rafia S
RS
Balkrishnan
Rajesh
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012737:Sex Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D014481:United States; D055815:Young Adult
D006993:Hypnotics and Sedatives