High Prevalence of Inappropriate Benzodiazepine and Sedative Hypnotic Prescriptions among Hospitalized Older Adults

Pek, Elisabeth Anna; Remfry, Andrew; Pendrith, Ciara; Fan‐Lun, Chris; Bhatia, R Sacha; Soong, Christine

doi:10.12788/jhm.2739

Cited by 39 publications

(44 citation statements)

References 23 publications

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“…Therefore, medical and scientific associations do not recommend the routine prescription of cholesterol‐lowering medication in adults over 70 years old (Charlesworth et al., ). Also surprising is the increased consumption of tranquillisers, relaxants and sleeping pills from 2006–2014, although studies have shown that most benzodiazepines are PIMs and are not recommended as first‐line drugs to treat insomnia due to the negative effects they cause, such as cognitive impairment or falls (Pek et al., ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with polypharmacy in the older people: 2006–2014

Carmona‐Torres

Cobo-Cuenca

Recio-Andrade

et al. 2018

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with polypharmacy in the older people: 2006–2014

Carmona‐Torres

Cobo-Cuenca

Recio-Andrade

et al. 2018

Journal of Clinical Nursing

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“…The proportion of SH prescription renewal at discharge achieved 38.7% in patients discharged home and 56.0% in patients discharged to rehabilitation facilities. This is a particularly high proportion compared to two other French studies (population: adult inpatients all ages), one Australian study (population: adult inpatients all ages) and one Canadian study (population: adult aged 65 and over) who reported a proportion of renewal at discharge comprised between 10.1 and 35.7% [ 16 , 18 , 19 , 22 ]. According to Zisberg et al, about one third of post-discharge new SH users had the first prescription of it during hospital stay, making hospitalization a turning point for new SH use in older people [ 20 ].…”

Section: Discussionmentioning

confidence: 79%

“…Hospitalization could thus be a period at risk for SH initiation. Studies published from 1996 to 2014 report an initiation of SHs for 8.3 to 44.6% of hospitalized patients, all ages combined [ 15 – 22 ]. Moreover, initiation of SHs during hospitalization has been shown to be a risk factor for long-term SH prescription after discharge (OR = 4.65, 95% confidence interval: [1.95–11.09]) [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study

et al. 2018

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BackgroundSedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hospital stay of older patients, the proportion of SH renewal at discharge among these patients and to study associated risk factors.MethodsWe conducted a retrospective observational study in six internal medicine units and six acute geriatric units in eight hospitals (France). We included 1194 inpatients aged 65 and older without SH medications prior to hospitalization. Data were obtained from patients’ electronic pharmaceutical records. Primary outcome was the cumulative incidence of SH initiation in the study units. Secondary outcomes were the proportion of SH renewal at discharge and risk factors for SH initiation and renewal at discharge (patient characteristics, hospital organization). A Cox regression model was used to study risk factors for SH initiation. A mixed effects logistic regression was used to study risk factors for SH renewal at discharge.ResultsSH initiation occurred in 21.5% of participants 20 days after admission. SH renewal at discharge occurred in 38.7% of patients who had initiated it during their stay and were discharged home and in 56.0% of patients discharged to rehabilitation facilities. Neither patients’ characteristics nor hospital organization patterns was associated with SH initiation. SH initiation after the first six days after admission was associated with a lower risk of SH renewal in patients discharged to rehabilitation facilities (OR = 0.19, 95% CI: [0.04–0.80]).ConclusionsHospitalization is a period at risk for SH initiation. The implementation of interventions promoting good use of SHs is thus of first importance in hospitals. Specific attention should be paid to patients discharged to rehabilitation facilities.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0972-3) contains supplementary material, which is available to authorized users.

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“…However, psychological treatment for late-life insomnia is often overlooked in favor of pharmaceutical treatments, in particular prescription of benzodiazepines and other sedative-hypnotics [22]. Yet, the long-term benefits of sedative hypnotics on sleep remain dubious, and their use has been linked to a host of negative outcomes, to include memory impairment, falls, fractures, and motor vehicle accidents [23–27].…”

Section: Psychological Treatment Options For Late-life Insomniamentioning

confidence: 99%

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

Dzierzewski

Griffin

Ravyts

et al. 2018

Curr Sleep Medicine Rep

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Purpose of Review: Late-life insomnia is a serious medical condition associated with many untoward consequences. The high prevalence of late-life insomnia, along with the concomitant risks inherent in the use of hypnotic medications in older adults necessitates non-pharmacological (i.e., psychological) treatment options. We aim to summarize and evaluate the state-of-the-science of psychological treatment options for late-life insomnia. Recent Findings: Cumulative scientific evidence suggests the efficacy of psychological treatment of late-life insomnia. During the previous decade, trials of psychological treatments for insomnia have begun to test various modifications to treatments that have the potential to improve access for older adults, along with expanding their focus to include individuals with comorbid conditions that are common to older adults. While these modifications represent positive advances in the science of treatment for late-life insomnia, the evidence is still largely explanatory/efficacious in nature. Summary: Psychological strategies represent the best approaches for the treatment of late-life insomnia. Future investigations would be wise to progressively move towards increasingly pragmatic/effectiveness investigations, adding to the literature base regarding the treatment of late-life insomnia under usual/real-world conditions as opposed to ideal/artificial conditions.

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High Prevalence of Inappropriate Benzodiazepine and Sedative Hypnotic Prescriptions among Hospitalized Older Adults

Cited by 39 publications

References 23 publications

Prevalence and factors associated with polypharmacy in the older people: 2006–2014

Prevalence and factors associated with polypharmacy in the older people: 2006–2014

Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study

Psychological Interventions for Late-Life Insomnia: Current and Emerging Science

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