title: Characteristics and Trends in Hypnotics Consumption in the Largest Health Care System in Israel.
abstract: Objectives. To quantify and characterize hypnotics consumption habits among adult patients insured by Clalit Health Services (CHS), the largest health care provider in Israel, in 2000 and 2010. Methods. A retrospective analysis of CHS computerized pharmacy records. Data were collected for all patients over the age of 18 years who were prescribed hypnotics in 2000 and in 2010. Results. Sleep medications were consumed by 8.7% of the adult CHS population in 2000 and by 9.6% in 2010. About one-quarter of consumers were treated for more than 6 months in both years. Multiple sleeping drugs were consumed more often in 2010 (45.2%) than a decade before (22%). While in 2000 benzodiazepines accounted for 84.5% of hypnotics, in 2010 this was reduced to 73.7% (p < 0.05). Of all patients treated for longer than 6 months only 11% in 2000 and 9% in 2010 required a dose escalation suggesting the absence of tolerance. Conclusions. Nine percent of the Israeli population consumes hypnotics. There is a major increase in prescription of combination of medications between 2000 and 2010, with an increase in Z class medications use and reduction in benzodiazepines. Most patients chronically treated did not escalate dosage, suggesting the absence of tolerance.
authors.affiliation: Sleep Clinic, Clalit Health Services, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: O
authors.identifier: 0000-0003-2933-8972
authors.initials: O
authors.lastname: Marom
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel; Office of Chief Physician, Clalit Health Services, Tel Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Rennert
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Stein
authors.affiliation: Department of Community Medicine and Epidemiology, Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel.
authors.forename: K
authors.initials: K
authors.lastname: Landsman
authors.affiliation: Sleep Clinic, Clalit Health Services, Technion Faculty of Medicine, Haifa, Israel.
authors.forename: G
authors.identifier: 0000-0002-0553-4226
authors.initials: G
authors.lastname: Pillar