Montreal—Benzodiazepine and nonbenzodiazepine sedatives are prescribed to as many as one in three hospitalized geriatric patients, with many of them taking home prescriptions for the medication when they leave the hospital.
A new study in the Journal of the American Geriatrics Society points out that lorazepam, clonazepam, zopiclone, and similar drugs raise the risk for falls, fractures, cognitive deficits, and even death in this cohort. It also emphasizes that clinical guidelines recommend against using those drugs as first-line agents for sleep issues, agitation, or delirium, but they also are prescribed for those conditions.
A study team led by Canadian researchers from McGill University sought to identify methods to help get older adults off sedatives. They looked for ways to distribute the “EMPOWER” patient-education brochure, as well as opportunities to use hospitalization to reduce inappropriate sedative prescribing.
Sequential recruitment was used until 30-day follow-up telephone and pharmacy records were acquired for 50 patients from a 52-bed clinical teaching unit in Montréal, Canada.
Participating were inpatients 65 and older who were chronic, regular sedative users. Frailty was an issue for nearly 70% of the patients, with 42% reporting a fall within the past month.
Defined as the primary outcome was short-term sustained cessation 30 days after discharge. Self-reported sleep disturbance before and after the intervention was the secondary outcome.
Results indicate that sedatives were deprescribed in 64%—32 of 50—participants who received the EMPOWER brochure. That substantially exceeded the historical rate of 21%, study authors point out.
At the same time, they said, the patients did not complain of significant worsening in their quality of sleep after ceasing to use sedatives.
“Hospitalized individuals are willing to deprescribe and contact with the healthcare system provides the opportunity to initiate the process with educational brochures,” study authors conclude. “This type of intervention requires few resources and is feasible and inexpensive.”
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A new study in the Journal of the American Geriatrics Society points out that lorazepam, clonazepam, zopiclone, and similar drugs raise the risk for falls, fractures, cognitive deficits, and even death in this cohort. It also emphasizes that clinical guidelines recommend against using those drugs as first-line agents for sleep issues, agitation, or delirium, but they also are prescribed for those conditions.
A study team led by Canadian researchers from McGill University sought to identify methods to help get older adults off sedatives. They looked for ways to distribute the “EMPOWER” patient-education brochure, as well as opportunities to use hospitalization to reduce inappropriate sedative prescribing.
Sequential recruitment was used until 30-day follow-up telephone and pharmacy records were acquired for 50 patients from a 52-bed clinical teaching unit in Montréal, Canada.
Participating were inpatients 65 and older who were chronic, regular sedative users. Frailty was an issue for nearly 70% of the patients, with 42% reporting a fall within the past month.
Defined as the primary outcome was short-term sustained cessation 30 days after discharge. Self-reported sleep disturbance before and after the intervention was the secondary outcome.
Results indicate that sedatives were deprescribed in 64%—32 of 50—participants who received the EMPOWER brochure. That substantially exceeded the historical rate of 21%, study authors point out.
At the same time, they said, the patients did not complain of significant worsening in their quality of sleep after ceasing to use sedatives.
“Hospitalized individuals are willing to deprescribe and contact with the healthcare system provides the opportunity to initiate the process with educational brochures,” study authors conclude. “This type of intervention requires few resources and is feasible and inexpensive.”
« Click here to return to Weekly News Update.
