{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:47:57Z","timestamp":1773006477850,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K14411"],"award-info":[{"award-number":["23K14411"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of the medical fee revisions related to polypharmacy in Japan on the long\u2010term hypnotic prescriptions in older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We utilized the JMDC medical institution database. Outpatients and inpatients aged\u2009\u2265\u200950\u2009years were included. The target hypnotics included benzodiazepines (BZDs), z\u2010drugs, and ramelteon and orexin receptor antagonists (ramelteon\/ORAs). The incidence rates of the newly initiated \u2265\u20094\u2009weeks of prescriptions per 10\u2009000 outpatients and inpatients (LP\u2010rate) in each month from 2015 to 2022 were calculated. An interrupted time\u2010series analysis was conducted with the intervention point of April 2020 when the medical fees were revised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average number of outpatients and inpatients in the database from 2015 to 2022 was 828,510\/month. The LP\u2010rates of BZDs and z\u2010drugs gradually decreased from 210 to 125 and 111 to 78.6, respectively, from January 2015 to December 2022, whereas that of ramelteon\/ORAs increased from 7.41 to 54.4. In the LP\u2010rate of BZDs and z\u2010drugs, although the level significantly increased by factors of 1.08 [95% confidence interval (CI): 1.02\u20131.13] and 1.12 [95% CI: 1.08\u20131.16], respectively, at the intervention time, the slope change significantly decreased after the intervention (0.990 [95% CI: 0.988\u20130.992] and 0.994 [95% CI: 0.993\u20130.996]). In ramelteon\/ORAs, the slope change with the increasing trend was significantly attenuated after the intervention (0.991 [95% CI: 0.986\u20130.995]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The medical fee revisions related to polypharmacy significantly redirected the long\u2010term prescription trends of BZDs, z\u2010drugs, and ramelteon\/ORAs toward a decline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70376","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T07:39:47Z","timestamp":1769758787000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of the Medical Policy Intervention for Polypharmacy on Long\u2010Term Prescriptions of Hypnotic Medications in Older Patients: An Interrupted Time\u2010Series Analysis Using a Nationwide Claims Database in Japan"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5254-3507","authenticated-orcid":false,"given":"Takeshi","family":"Kimura","sequence":"first","affiliation":[{"name":"Department of Pharmacy Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kobe University Hospital  Kobe Japan"},{"name":"Department of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences Okayama University  Okayama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryunosuke","family":"Saeki","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Omura","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikuko","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Kobe University Hospital  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afu029"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1103053"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjopharm.2007.12.002"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/61.2.170"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03628.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-75888-8"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-04096-6"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38623.768588.47"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200418010-00004"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.357"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-02757-6"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharma.2009.07.001"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18372"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-023-00777-y"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12890"},{"key":"e_1_2_12_17_1","unstructured":"International Narcotics Control Board United Nations \u201cReport of the International Narcotics Control Board for 2015 (E\/INCB\/2015\/1). 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