Insights from PowerBI: Melatonin use

An occasional series illustrating the value of using PowerBI to explore your own data. This issue focuses on 'off label' use of melatonin.

Do you have any children on your books taking melatonin ?  

Melatonin is a pineal hormone that may affect sleep pattern. It is approved in New Zealand for short term use in people over the age of 55 years with primary insomnia. All other uses are 'off label'.  

Side effects are minimal, and melatonin is available in many countries as an over the counter medication.  

Clinical experience suggests that when appropriate behavioural sleep interventions fail, melatonin may be of value for treating sleep onset insomnia and delayed sleep phase syndrome in children with conditions such as visual impairment, cerebral palsy, attention deficit hyperactivity disorder, autism, and learning difficulties.  

Treatment of children with melatonin should be initiated and supervised by a specialist but may be continued by general practitioners under a shared-care arrangement. The need to continue melatonin therapy should be reviewed every six months.  

This is because little is known about melatonin’s long-term effects in children, and there is uncertainty as to the effect on other circadian rhythms including endocrine and reproductive hormone secretion.  

Insights from PowerBI 

Across the Pinnacle network in 2020, the majority of prescriptions for melatonin were dispensed 'off label' with 6,874 prescriptions given for people under 55 vs 1,536 prescriptions given for people over 55.

• 0-4 years: 146 prescriptions.
• 5-14 years: 1,999 prescriptions.
• 15-24 years: 872 prescriptions.
• 25-44 years: 960 prescriptions.
• 45-64 years: 1,267 prescriptions.
• 65+ years: 865.

Māori were prescribed melatonin less than expected compared to the size of the population. Eight per cent of prescriptions for adults over 25 were for patients who identify as Māori, when 12 per cent of this population are Māori. 

What's happening in your practice? You can use PowerBI to find out. 

For more information

PowerBI is a data visualisation tool you can use to explore your practice's data. For information about how to access PowerBI please contact the practice systems support team (updated 23.11.23).

For more information about melatonin see the New Zealand Formulary or the melatonin bulletins on SaferX.

If you have insights you'd like to share, or questions you'd like to explore please contact Dr Jo Scott-Jones.