Benzodiazepine und Z-Substanzen als Schlaf- und Beruhigungsmittel in einem Krankenhaus

Abstract

Aim | Benzodiazepines and Z-drugs are frequently prescribed sleep medications in spite of their poor risk-benefit ratio when used over a longer period of time. The aim of the study was to find out how the medical and nursing staff in a general hospital estimated the frequency of use for these drugs, and the risk-benefit ratio for elderly patients as well as the factors which positively influence the perceived use of these drugs. Methods | All members of the medical and nursing staff of a hospital received a questionnaire about their use of, and attitudes towards, benzodiazepines and Z-drugs. Absolute and relative frequencies were calculated to estimate the perceived frequency of use and the risk-benefit ratio. Multiple logistic regressions were used to analyze which factors are associated with a perceived high use of benzodiazepines or Z-drugs for insomnia. Results | More nurses than hospital doctors believed that they dispensed benzodiazepines often or always (57 % vs. 29 %) to patients with insomnia; this was also the case for Z-drugs (66 % vs. 29 %). Nearly half of the hospital doctors and 29 % of the nurses perceived more harms than benefits for benzodiazepines in the elderly. The following factors were associated with a high perceived usage of Z-drugs: working as a nurse (OR: 13,95; 95%-CI: 3,87-50,28), working in a non-surgical department (5,41; 2,00-14,61), having < 5 years of professional experience (4,90; 1,43-16,81) and feeling that the benefits of Z-drugs outweigh the risks for elderly patients (5,07; 1,48-17,35). For benzodiazepines, only the perceived positive risk-benefit ratio had an influence on the perceived use (3,35; 1,28-8.79). Conclusion | The medical and nursing staff perceived the frequency of prescription of benzodiazepines and Z-drugs and the risk-benefit ratio in different ways. Other aspects, such as working in a non-surgical department or having a smaller amount of working experience may also influence the decision to use Z-drugs.

The interplay of context factors in hypnotic and sedative prescription in primary and secondary care—a qualitative study

“…The topics of the guide (see Table 1 and Appendices 1 and 2) were drawn from current literature and a previous quantitative survey [21] and were informed by the experience of clinical members of the research team.…”

“…The interview guide was developed and tested in four pilot interviews with GPs and hospital doctors who were not included in the sampling frame. The topics of the guide (see Table 1 and Appendices 1 and 2) were drawn from current literature and a previous quantitative survey [ 21 ] and were informed by the experience of clinical members of the research team.…”

Why Z-drugs are used even if doctors and nurses feel unable to judge their benefits and risks—a hospital survey

“…The study was approved by the Ethics Committee of Göttingen University Medical Center (25/2/14). Parts of the survey results have already been analyzed and published [13,14], with a focus on benzodiazepines.…”

Nicht-medikamentöse Maßnahmen bei Ein- und Durchschlafproblemen von älteren Patienten im Krankenhaus – Qualitative Interviews mit Pflegenden

“…Während einer vorangegangen standardisierten Befra gung von Pflegenden (Weiß et al, 2016) wurde sehr deut lich, dass diese sich ungern über die Ausgabe von Schlaf und Beruhigungsmitteln äußern. Mangelndes Fachwissen und das Gefühl, etwas Unrechtes oder Falsches zu tun, waren offensichtlich ausschlaggebend für eine geringe Rücklaufquote der Fragebögen.…”