The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database

碩士 === 國立陽明大學 === 醫務管理研究所 === 101 === Background Given the fact that sleep disorders, especially chronic insomnia have become one of the major health problems, the use of hypnotics is steadily increasing. However, no studies with large sample size and long-term observation have been conducted to inv...

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Main Authors: Ya-Fang Zeng, 曾雅芳
Other Authors: Tzuo-Yun Lan
Format: Others
Language:zh-TW
Published: 2013
Online Access:http://ndltd.ncl.edu.tw/handle/22899259860955109089
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spelling ndltd-TW-101YM0055280032016-03-18T04:41:51Z http://ndltd.ncl.edu.tw/handle/22899259860955109089 The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database 以全民健保長期追蹤資料探討使用安眠藥之健康效應 Ya-Fang Zeng 曾雅芳 碩士 國立陽明大學 醫務管理研究所 101 Background Given the fact that sleep disorders, especially chronic insomnia have become one of the major health problems, the use of hypnotics is steadily increasing. However, no studies with large sample size and long-term observation have been conducted to investigate the relationship between specific hypnotics and health effect. Objective To investigate the relationship between specific hypnotics and health effect, including mortality, cancer, chronic kidney disease and asthma. Methods Data sources were the one-million cohort of 2000 and 2005 Longitudinal National Health Insurance Research Database. Information included outpatient, emergency, hospital and pharmacy claims data from 2000 to 2009. The 1,320,322 subjects were aged 18 and over, and the use of hypnotics was divided into 5 groups: zolpidem users, other non-BZDs users, BZDs users, mixed users and non-users. Data were adjustrd for gender, age and comorbidity. Hazard ratio (HR) was calculated from Cox proportional hazards model. Results Mortality: Compared to the non-users, both BZDs (HRCCI=1.56, 95% CI: 1.53-1.59; HRElix=1.81, 95% CI: 1.78-1.85) and mixed users (HRCCI=1.08, 95% CI: 1.06-1.10; HRElix=1.44, 95% CI: 1.42-1.47) had higher risk of death, whereas other non-BZDs users (HRCCI=0.90, 95% CI: 0.86-0.95; HRElix=1.00, 95% CI: 0.95-1.05) did not have differences and zolpidem users (HRCCI=0.64, 95% CI: 0.63-0.66; HRElix=0.73, 95% CI: 0.71-0.75) exhibited lower risk of mortality in the adjusted models. This pattern remained similar after considering two matching techniques. The secondary analyses indicated that zolpidem users showed reduced risk of major cause-specific deaths except cancer and the protection effect was dose-response, with over one-year use having the lowest HR. Cancer: Compared to the non-users, hypnotics did not have differences risk of cancer. Chronic kidney disease: Compared to the non-users, hypnotics did not have differences risk of chronic kidney disease. Asthma: Compared to the non-users, hypnotics did not have differences risk of asthma. Conclusions The use of benzodiazepines or two types of hypnotics had higher risk on mortality, and zolpidem had lower risk on mortality. However, the use of hypnotics didn’t show different effect on cancer, chronic kidney or asthma. Tzuo-Yun Lan Gau-Jun Tang 藍祚運 唐高駿 2013 學位論文 ; thesis 105 zh-TW
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description 碩士 === 國立陽明大學 === 醫務管理研究所 === 101 === Background Given the fact that sleep disorders, especially chronic insomnia have become one of the major health problems, the use of hypnotics is steadily increasing. However, no studies with large sample size and long-term observation have been conducted to investigate the relationship between specific hypnotics and health effect. Objective To investigate the relationship between specific hypnotics and health effect, including mortality, cancer, chronic kidney disease and asthma. Methods Data sources were the one-million cohort of 2000 and 2005 Longitudinal National Health Insurance Research Database. Information included outpatient, emergency, hospital and pharmacy claims data from 2000 to 2009. The 1,320,322 subjects were aged 18 and over, and the use of hypnotics was divided into 5 groups: zolpidem users, other non-BZDs users, BZDs users, mixed users and non-users. Data were adjustrd for gender, age and comorbidity. Hazard ratio (HR) was calculated from Cox proportional hazards model. Results Mortality: Compared to the non-users, both BZDs (HRCCI=1.56, 95% CI: 1.53-1.59; HRElix=1.81, 95% CI: 1.78-1.85) and mixed users (HRCCI=1.08, 95% CI: 1.06-1.10; HRElix=1.44, 95% CI: 1.42-1.47) had higher risk of death, whereas other non-BZDs users (HRCCI=0.90, 95% CI: 0.86-0.95; HRElix=1.00, 95% CI: 0.95-1.05) did not have differences and zolpidem users (HRCCI=0.64, 95% CI: 0.63-0.66; HRElix=0.73, 95% CI: 0.71-0.75) exhibited lower risk of mortality in the adjusted models. This pattern remained similar after considering two matching techniques. The secondary analyses indicated that zolpidem users showed reduced risk of major cause-specific deaths except cancer and the protection effect was dose-response, with over one-year use having the lowest HR. Cancer: Compared to the non-users, hypnotics did not have differences risk of cancer. Chronic kidney disease: Compared to the non-users, hypnotics did not have differences risk of chronic kidney disease. Asthma: Compared to the non-users, hypnotics did not have differences risk of asthma. Conclusions The use of benzodiazepines or two types of hypnotics had higher risk on mortality, and zolpidem had lower risk on mortality. However, the use of hypnotics didn’t show different effect on cancer, chronic kidney or asthma.
author2 Tzuo-Yun Lan
author_facet Tzuo-Yun Lan
Ya-Fang Zeng
曾雅芳
author Ya-Fang Zeng
曾雅芳
spellingShingle Ya-Fang Zeng
曾雅芳
The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
author_sort Ya-Fang Zeng
title The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
title_short The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
title_full The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
title_fullStr The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
title_full_unstemmed The Use of Hypnotics and Health: Results from the Long-Term NHI Research Database
title_sort use of hypnotics and health: results from the long-term nhi research database
publishDate 2013
url http://ndltd.ncl.edu.tw/handle/22899259860955109089
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