Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis
Abstract Background There is limited research on real-world utilization patterns of benzodiazepines and Z-drugs (collectively-termed benzodiazepine-receptor agonists [BZRAs]) in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of BZRA prescribing-p...
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2025-02-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06515-x |
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| author | Carltin Chun Ting Kwok Heidi Ka Ying Lo Ching Yui Chan Joe Kwun Nam Chan Corine Sau Man Wong Calvin Pak Wing Cheng Chung Ho Brian Man Ho Leung Wilfred Shone Horn Wong Zoe Hoi Shuen Yu Edwin Ho Ming Lee Wing Chung Chang |
| author_facet | Carltin Chun Ting Kwok Heidi Ka Ying Lo Ching Yui Chan Joe Kwun Nam Chan Corine Sau Man Wong Calvin Pak Wing Cheng Chung Ho Brian Man Ho Leung Wilfred Shone Horn Wong Zoe Hoi Shuen Yu Edwin Ho Ming Lee Wing Chung Chang |
| author_sort | Carltin Chun Ting Kwok |
| collection | DOAJ |
| description | Abstract Background There is limited research on real-world utilization patterns of benzodiazepines and Z-drugs (collectively-termed benzodiazepine-receptor agonists [BZRAs]) in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of BZRA prescribing-practice among children, adolescents and young adults in Hong Kong over a 21-year period. Methods This population-based study identified 60,660 individuals aged 4–24 years who had redeemed ≥ 1 BZRA prescription within 2000–2020, using data from medical-record database of Hong Kong public-healthcare-services. We calculated annual prescription prevalence (per 1,000 persons per year) for any BZRA, BZRA-subtypes (short- and long-acting benzodiazepines, Z-drugs) and individual BZRAs. Joinpoint-regression analyses were performed to assess temporal BZRA prescription trends, quantified by average annual-percent-change (AAPC), with 95% confidence-intervals (CIs). Results Overall BZRA prescription prevalence significantly increased (AAPC: 5.70% [95%CI: 5.31-6.54%]), from 1.88 in 2000 to 5.69 in 2020, uniformly across both sexes. Young adults (18–24 years-old) displayed the highest prescription prevalence, followed by adolescents (12–17 years-old) and children (4–11 years-old). Young adults and adolescents exhibited more pronounced increased BZRA use than children. Use of all BZRA subtypes consistently increased over time for all age-groups, except decline in Z-drug prescriptions in children. Lorazepam and diazepam represented the two most frequently-prescribed individual BZRAs, whereas alprazolam use showed the steepest increase. Anxiety and depression emerged as the most commonly-assigned diagnoses for BZRA-users. Conclusion This first Asian population-based study indicates a significant rising trend of BZRA prescriptions, especially among adolescents and young adults. Judicious prescribing-practices and further investigation clarifying factors contributing to increased BZRA use are warranted. |
| format | Article |
| id | doaj-art-6408076e262741a3ba90e663ba04a0ed |
| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-02-01 |
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| series | BMC Psychiatry |
| spelling | doaj-art-6408076e262741a3ba90e663ba04a0ed2025-02-09T12:49:20ZengBMCBMC Psychiatry1471-244X2025-02-012511910.1186/s12888-025-06515-xTemporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysisCarltin Chun Ting Kwok0Heidi Ka Ying Lo1Ching Yui Chan2Joe Kwun Nam Chan3Corine Sau Man Wong4Calvin Pak Wing Cheng5Chung Ho6Brian Man Ho Leung7Wilfred Shone Horn Wong8Zoe Hoi Shuen Yu9Edwin Ho Ming Lee10Wing Chung Chang11Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongSchool of Public Health, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongChild and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital AuthorityChild and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital AuthorityChild and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital AuthorityChild and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital AuthorityDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong KongAbstract Background There is limited research on real-world utilization patterns of benzodiazepines and Z-drugs (collectively-termed benzodiazepine-receptor agonists [BZRAs]) in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of BZRA prescribing-practice among children, adolescents and young adults in Hong Kong over a 21-year period. Methods This population-based study identified 60,660 individuals aged 4–24 years who had redeemed ≥ 1 BZRA prescription within 2000–2020, using data from medical-record database of Hong Kong public-healthcare-services. We calculated annual prescription prevalence (per 1,000 persons per year) for any BZRA, BZRA-subtypes (short- and long-acting benzodiazepines, Z-drugs) and individual BZRAs. Joinpoint-regression analyses were performed to assess temporal BZRA prescription trends, quantified by average annual-percent-change (AAPC), with 95% confidence-intervals (CIs). Results Overall BZRA prescription prevalence significantly increased (AAPC: 5.70% [95%CI: 5.31-6.54%]), from 1.88 in 2000 to 5.69 in 2020, uniformly across both sexes. Young adults (18–24 years-old) displayed the highest prescription prevalence, followed by adolescents (12–17 years-old) and children (4–11 years-old). Young adults and adolescents exhibited more pronounced increased BZRA use than children. Use of all BZRA subtypes consistently increased over time for all age-groups, except decline in Z-drug prescriptions in children. Lorazepam and diazepam represented the two most frequently-prescribed individual BZRAs, whereas alprazolam use showed the steepest increase. Anxiety and depression emerged as the most commonly-assigned diagnoses for BZRA-users. Conclusion This first Asian population-based study indicates a significant rising trend of BZRA prescriptions, especially among adolescents and young adults. Judicious prescribing-practices and further investigation clarifying factors contributing to increased BZRA use are warranted.https://doi.org/10.1186/s12888-025-06515-xBenzodiazepinesZ-drugsPrescribing trendsChildren & adolescentsPharmacoepidemiologyPopulation-based |
| spellingShingle | Carltin Chun Ting Kwok Heidi Ka Ying Lo Ching Yui Chan Joe Kwun Nam Chan Corine Sau Man Wong Calvin Pak Wing Cheng Chung Ho Brian Man Ho Leung Wilfred Shone Horn Wong Zoe Hoi Shuen Yu Edwin Ho Ming Lee Wing Chung Chang Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis BMC Psychiatry Benzodiazepines Z-drugs Prescribing trends Children & adolescents Pharmacoepidemiology Population-based |
| title | Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis |
| title_full | Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis |
| title_fullStr | Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis |
| title_full_unstemmed | Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis |
| title_short | Temporal trends of the utilization patterns of sedative-hypnotic medications in children, adolescents and young adults: a 21-year population-based study with joinpoint regression analysis |
| title_sort | temporal trends of the utilization patterns of sedative hypnotic medications in children adolescents and young adults a 21 year population based study with joinpoint regression analysis |
| topic | Benzodiazepines Z-drugs Prescribing trends Children & adolescents Pharmacoepidemiology Population-based |
| url | https://doi.org/10.1186/s12888-025-06515-x |
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