Reducing the use of sleep-inducing drugs during hospitalisation by a multi-faceted intervention : a pilot study
© European Association of Hospital Pharmacists 2024. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ..
OBJECTIVES: Many patients receive benzodiazepines or Z-drugs during hospitalisation due to sleeping problems. In a pilot study, we aimed to find out whether, and to what degree, a multi-faceted intervention can reduce the use of these drugs, especially in older patients and those without a psychiatric or neurological disorder. The results of this pilot study should inform the design of a randomised controlled trial (RCT).
METHODS: In a quasi-experimental design, we implemented the intervention in a German hospital with the support of the hospital director, medical and nursing staff and employee representatives. We compared prescription data for sleep-inducing drugs before and after the intervention by Fisher's exact test and used odds ratios (ORs) with their 95% CIs as a measure of effect size.
RESULTS: The data from 960 patients aged ≥65 years before intervention and 1049 patients after intervention were analysed. Before intervention, 483 (50.3%) of the patients received sleep-inducing drugs at some time during their hospital stay. After the intervention, 381 (36.3%) patients received a sleep-inducing drug, resulting in an OR of 0.56 (95% CI 0.47 to 0.68) (p<0.001). The reduction was particularly pronounced in patients without a psychiatric or neurological disorder (from 45.0% to 28.8%). In particular, the consumption of benzodiazepines declined from 24.3% to 8.5% (OR 0.31; 95% CI 0.23 to 0.4) (p<0.001).
CONCLUSIONS: A multi-faceted intervention to change the practice of the use of sleep-inducing drugs in one hospital was successful in terms of drug reduction, particularly for benzodiazepines. The intervention was effective especially for target persons-that is, those without a psychiatric or neurological disease. Awareness of the magnitude of the change and the role of important stakeholders could help researchers and hospital staff to design a large RCT, including control hospitals, to evaluate the success of a multi-faceted intervention on a scientifically sound basis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
European journal of hospital pharmacy : science and practice - 31(2024), 2 vom: 22. Feb., Seite 117-123 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Heinemann, Stephanie [VerfasserIn] |
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| Links: |
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| Themen: |
12794-10-4 |
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| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 07.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/ejhpharm-2021-003097 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Reducing the use of sleep-inducing drugs during hospitalisation by a multi-faceted intervention |b a pilot study |
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| 520 | |a © European Association of Hospital Pharmacists 2024. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. | ||
| 520 | |a OBJECTIVES: Many patients receive benzodiazepines or Z-drugs during hospitalisation due to sleeping problems. In a pilot study, we aimed to find out whether, and to what degree, a multi-faceted intervention can reduce the use of these drugs, especially in older patients and those without a psychiatric or neurological disorder. The results of this pilot study should inform the design of a randomised controlled trial (RCT) | ||
| 520 | |a METHODS: In a quasi-experimental design, we implemented the intervention in a German hospital with the support of the hospital director, medical and nursing staff and employee representatives. We compared prescription data for sleep-inducing drugs before and after the intervention by Fisher's exact test and used odds ratios (ORs) with their 95% CIs as a measure of effect size | ||
| 520 | |a RESULTS: The data from 960 patients aged ≥65 years before intervention and 1049 patients after intervention were analysed. Before intervention, 483 (50.3%) of the patients received sleep-inducing drugs at some time during their hospital stay. After the intervention, 381 (36.3%) patients received a sleep-inducing drug, resulting in an OR of 0.56 (95% CI 0.47 to 0.68) (p<0.001). The reduction was particularly pronounced in patients without a psychiatric or neurological disorder (from 45.0% to 28.8%). In particular, the consumption of benzodiazepines declined from 24.3% to 8.5% (OR 0.31; 95% CI 0.23 to 0.4) (p<0.001) | ||
| 520 | |a CONCLUSIONS: A multi-faceted intervention to change the practice of the use of sleep-inducing drugs in one hospital was successful in terms of drug reduction, particularly for benzodiazepines. The intervention was effective especially for target persons-that is, those without a psychiatric or neurological disease. Awareness of the magnitude of the change and the role of important stakeholders could help researchers and hospital staff to design a large RCT, including control hospitals, to evaluate the success of a multi-faceted intervention on a scientifically sound basis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CLINICAL MEDICINE | |
| 650 | 4 | |a Controlled Clinical Trial | |
| 650 | 4 | |a Drug Misuse | |
| 650 | 4 | |a Drug Monitoring | |
| 650 | 4 | |a Quality of Health Care | |
| 650 | 4 | |a SLEEP MEDICINE SPECIALTY | |
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| 650 | 7 | |a 12794-10-4 |2 NLM | |
| 700 | 1 | |a Klemperer, Jonas |e verfasserin |4 aut | |
| 700 | 1 | |a Hummers, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Nau, Roland |e verfasserin |4 aut | |
| 700 | 1 | |a Himmel, Wolfgang |e verfasserin |4 aut | |
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