Initial Rx length tied to long-term use of Z-drugs
Patients who receive a longer initial Z-drug prescription are more likely to fill additional prescriptions after the index fill year, including up to seven years later, according to a research letter published online Sept. 3 in JAMA Network Open.
A research letter published in JAMA Network Open suggests that patients who receive a longer initial prescription of Z-drugs, such as zolpidem, eszopiclone, or zaleplon, are more likely to continue taking the medication long-term. The study, led by Jonathan N. Cloughesy from the University of Southern California, analyzed data from 129,287 patients who received a prescription for Z-drugs between 2007 and 2024. The mean initial prescription length was 27 days.
Patients who initially received a 1- to 14-day supply had a 15.6% chance of filling an additional Z-drug prescription within the first year, compared to 38.1% for those who received a 25- to 34-day supply and 49.5% for those with a prescription of 35 days or more (the adjusted risk difference for 25-34 days versus 1-14 days was 22.4 percentage points).
This trend persisted over time, with fill rates declining as the initial supply length increased. At seven years, 7.9% of patients who received a 1- to 14-day supply had filled a Z-drug prescription, compared to 18.9% of those with a prescription of 35 days or more (the adjusted risk difference for 25-34 days versus 1-14 days was 7.6 percentage points).
The study also found that patients with larger initial supplies were more likely to receive at least a 180-day supply of Z-drugs, and they received a greater mean annual supply of the medication. Cloughesy emphasized the importance of cautious prescribing when starting patients on sleep medications like Z-drugs, as the first prescription may significantly influence long-term use.
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