Newswise — In an early examination of racial disparities in insomnia treatment, a study by Regenstrief Institute and Indiana University reveals that non-White patients faced notably lower prescription rates for medication after being diagnosed with insomnia compared to White patients.
The findings revealed a significant discrepancy in the prescription rates of FDA-approved insomnia medications between Black patients and White patients. Black patients were notably less likely to receive such prescriptions at any point following their diagnosis. Similarly, individuals from other non-White backgrounds showed a significant decrease in the likelihood of being prescribed FDA-approved medications for insomnia two, three, and four years after their initial diagnosis, excluding the first year.
Co-author and Regenstrief Research Scientist, Dr. Malaz Boustani, emphasized that the study examined various factors, including comorbidities like anxiety disorders and depression, as well as individuals' residential locations, in order to understand the reasons behind the prescription disparities after an insomnia diagnosis. However, the study concluded that race was the sole variable that explained the variations in treatment.
According to the researchers' findings, although older patients and those with comorbidities were generally less likely to receive insomnia medication prescriptions regardless of race, White patients, on average, experienced a shorter time span between diagnosis and prescription compared to individuals from other racial backgrounds.
Insomnia, a prevalent sleep disorder, is characterized by challenges in initiating sleep, maintaining sleep, or obtaining satisfactory sleep quality. The U.S. Centers for Disease Control and Prevention highlight the significant correlation between inadequate sleep and several chronic diseases and conditions such as type 2 diabetes, heart disease, obesity, and depression.
Regenstrief Institute Research Scientist and study co-author, Dr. Noll Campbell, explained that the primary objective of the study was to identify patterns in insomnia treatment. The study aimed to determine whether the observed trends were influenced by individual patient preferences, collective preferences within specific groups, or variations in nonpharmacologic approaches to insomnia treatment. To gain a deeper understanding of the reasons behind these trends, further research will be necessary.
The study utilized data from approximately 10,000 individuals who were prescribed FDA-approved medications for insomnia. The data was obtained from the Indiana Network for Patient Care (INPC), which is administered by the Indiana Health Information Exchange. The INPC, established by Regenstrief Institute, serves as a platform that grants access to data specifically for research endeavors.
Dr. Paul Dexter, a study co-author and clinician-informatician at Regenstrief Institute, expressed deep appreciation for the Indiana Network for Patient Care as an invaluable resource in comprehending clinical practices. The INPC played a vital role by providing access to essential data encompassing demographics, diagnoses, medications, and clinical notes. This data was crucial for conducting the analysis on racial disparities in the prescription of insomnia medications.
The study's senior author, Dr. Arthur Owora, a Research Scientist at Regenstrief Institute, emphasized the significance of systematically analyzing electronic health records (EHR) data in identifying disparities and promoting equitable care. This study serves as an illustration of the potential of such analyses. However, Dr. Owora also advised exercising caution when interpreting results due to the limitations of secondary data sources. Further research is necessary to gain a better understanding of the role patient preferences and patient-clinician interactions may have played in the observed disparities in insomnia treatment.
The study population consisted of 75 percent White individuals, with 69 percent being female and 62 percent identifying as non-Hispanic. The average age at the time of insomnia diagnosis was 61 years. These demographic details provide insight into the composition of the participants involved in the study.
Emma Holler, MPH, the first author of the study and a doctoral student and clinical epidemiologist at Indiana University School of Public Health -- Bloomington, highlighted an additional finding from the data. In addition to uncovering racial disparities in the prescription of insomnia medications, the data also suggests that healthcare providers might be undertreating insomnia. This observation raises concerns regarding the level of attention and treatment provided to individuals with insomnia, indicating the need for further investigation and potential interventions.
“Racial disparities in the pharmacological treatment of insomnia: A time-to-event analysis using real-world data” is published in the peer-reviewed journal Sleep Medicine.
This work was supported in part by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
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