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Published in: CNS Drugs 6/2018

01-06-2018 | Original Research Article

Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea

Authors: Bo Ram Yang, Ye-Jee Kim, Mi-Sook Kim, Sun-Young Jung, Nam-Kyong Choi, Byungkwan Hwang, Byung-Joo Park, Joongyub Lee

Published in: CNS Drugs | Issue 6/2018

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Abstract

Background

Zolpidem is one of the most frequently used hypnotics worldwide, but associations with serious adverse effects such as motor vehicle collisions have been reported.

Objective

The objective of this study was to evaluate the association of fatal motor vehicle collisions with a prescription for zolpidem, considering the context of the motor vehicle collisions.

Methods

We conducted a case-crossover study, where each case served as its own control, by linking data about fatal motor vehicle collisions from the Korean Road Traffic Authority between 2010 and 2014 with national health insurance data. The case period was defined as 1 day before the fatal motor vehicle collisions, and was matched to four control periods at 90-day intervals. Conditional logistic regression was performed to calculate the odds ratio for fatal motor vehicle collisions associated with zolpidem exposure, and odds ratios were adjusted for time-varying exposure to confounding medications. A stratified analysis was performed by age group (younger than 65 years or not), the Charlson Comorbidity Index, and whether patients were new zolpidem users.

Results

Among the 714 subjects, the adjusted odds ratio for a fatal motor vehicle collision associated with a prescription for zolpidem the previous day was 1.48 (95% confidence interval 1.06–2.07). After stratification, a significantly increased risk was observed in subjects with a high Charlson Comorbidity Index (odds ratio 1.81; 95% confidence interval 1.16–2.84), the younger age group (odds ratio: 1.62; 95% confidence interval 1.03–2.56), and new zolpidem users (odds ratio 2.37; 95% confidence interval 1.40–4.00).

Conclusion

A prescription for zolpidem on the previous day was significantly related to an increased risk of fatal motor vehicle collisions in this population-based case-crossover study.
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Metadata
Title
Prescription of Zolpidem and the Risk of Fatal Motor Vehicle Collisions: A Population-Based, Case-Crossover Study from South Korea
Authors
Bo Ram Yang
Ye-Jee Kim
Mi-Sook Kim
Sun-Young Jung
Nam-Kyong Choi
Byungkwan Hwang
Byung-Joo Park
Joongyub Lee
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 6/2018
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.1007/s40263-018-0520-x

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