Psychotropic Drug Scheduling and Benzodiazepine Receptor Agonist Prescribing in Japan: An Interrupted Time Series Analysis.

BACKGROUND: This study aimed to evaluate the effects of psychotropic drug scheduling, including limiting the days' supply per prescription, on the prescriptions of etizolam and zopiclone, benzodiazepine receptor agonists (BZRAs), in Japan. METHODS: This study was based on the randomly sampled data from the national administrative health insurance claims data in Japan from 2012 to 2020. We analyzed age-specific trends in prescriptions of the two BZRAs, which were designated as psychotropic drugs in 2016. The impacts of psychotropic drug scheduling on the prescription trends were evaluated using interrupted time series analysis. RESULTS: After the scheduling, etizolam prescriptions showed an immediate decrease and a continuing decrease at a greater rate than before the intervention in patients aged 80 years or older (Level [per 10,000 people], -22.23, 95% CI -39.57, -4.88; Slope [per 10,000 people / 3 months], -8.07, 95% CI -10.14, -6.00). Among patients aged 80 years or older, the prescription of zopiclone decreased immediately after the scheduling, with no trend change (Level [per 10,000 people], -7.20, 95% CI -11.99, -2.42; Slope [per 10,000 people / 3 months], -0.04, 95% CI -0.61, 0.53). Changes in the other age groups were generally smaller than those observed in the ≥ 80 years group. CONCLUSIONS: Following the psychotropic scheduling, significant decreases in the prescription rates of etizolam and zopiclone were observed among patients aged 80 years or older. The effects of psychotropic drug scheduling of BZRAs on reducing prescriptions were modest and may be insufficient to substantially influence prescribing behavior, suggesting the need for additional or complementary approaches, such as clinician education and stricter medication review.