We used multivariable binomial regression to estimate the annual percentage change in dispensing, adjusted for age, sex, and depression diagnosis. Individuals with trazodone dispensed multiple times in a given year were counted only if all prescriptions dispensed were for low dosages. ![]() Low-dose trazodone was defined as less than 150 mg/d, which is commonly used for insomnia and below the starting dosage of 150 mg/d for depression. We used the dosage to identify whether trazodone was dispensed for insomnia because an insomnia diagnosis was not a reliable marker of treatment indication (in the MarketScan data, only 41% of adults dispensed zolpidem had an insomnia diagnosis, although zolpidem is only known to be used for insomnia). We calculated the annual percentage of adults with at least 1 dispensing of zolpidem or low-dose trazodone among all adults who contacted the health care system in a given year and had at least 12 months of prior continuous medical and drug insurance. The MarketScan databases contain health care and pharmacy claims from approximately 350 payers across the US and are considered generally representative of individuals with employer-provided insurance. Using the 2011 to 2018 IBM MarketScan Research Databases, we measured trends in dispensing of zolpidem and low-dose trazodone among adults (aged ≥18 years) with employer-sponsored insurance or Medicare supplemental plans. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine. ![]() Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.The short black dashes above the vertical bars indicate the 95% CIs around the annual percentages. Multivariable binomial regression models were used to estimate the annual percentage change in the dispensing of each drug in 2011 to 2018, adjusted for age, sex, and depression diagnosis, in which depression diagnosis was defined as having at least 2 outpatient codes or 1 inpatient code for depression in the past year. Individuals who had trazodone dispensed multiple times in a given year were counted only if all prescriptions dispensed were below the dose threshold to avoid counting individuals tapering up to or down from higher dosages (more likely indicated for depression). For each year, the percentage of adults who received at least 1 dispensing of low-dose trazodone (<150 mg/d or ≤50 mg/d) or any dosage of zolpidem was calculated among all adults who contacted the health care system in the year, had at least 12 months of prior continuous medical and drug insurance, and had a diagnosis code for insomnia recorded in the past year (mean of 781 790 adults per year in the MarketScan databases). The 2011 to 2018 IBM MarketScan Research Databases were used to measure trends in the dispensing of zolpidem and low-dose trazodone among US adults (aged ≥18 years) with employer-sponsored insurance or Medicare supplemental plans who had a diagnosis code for insomnia. For each year, the percentage of adults who received at least 1 dispensing of low-dose trazodone (<150 mg/d or ≤50 mg/d) or any dosage of zolpidem was calculated among all adults who contacted the health care system in the year and had at least 12 months of prior continuous medical and drug insurance (mean of 16.6 million adults per year in the MarketScan databases). ![]() The 2011 to 2018 IBM MarketScan Research Databases were used to measure trends in the dispensing of zolpidem and low-dose trazodone among US adults (aged ≥18 years) with employer-sponsored insurance or Medicare supplemental plans.
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