The Impact of a Pharmacist Intervention on Post-discharge Hypnotic Drug Discontinuation in Geriatric Inpatients: a Before-after Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 173
- 主要终点
- Hypnotic drug discontinuation at one month after discharge
研究概览
简要总结
This study investigated whether a multifaceted approach was associated with hypnotic drug discontinuation at one month after discharge
详细描述
Chronic use of hypnotic agents is prevalent in older adults, who as a result are at increased risk for certain adverse events, such as day-time drowsiness and falls. Multiple strategies to discontinue hypnotics have been tested in geriatric patients, but evidence remains scarce. Hence, we aimed to investigate a multicomponent intervention to reduce hypnotic drug use in geriatric inpatients.
A before-after study was performed on the acute geriatric wards of a teaching hospital. The before cohort received usual care while intervention patients were exposed to a pharmacist-led deprescribing intervention, comprising education of health care personnel, access to standardized discontinuation regimens, active patient involvement and support of transitional care. The primary outcome was hypnotic drug discontinuation at one month after discharge.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged ≥ 75 years
- •Admitted to an acute geriatric ward of UZ Leuven
- •Documented chronic use of a hypnotic drug (hypnotics were defined as benzodiazepines and Z-drugs and chronic hypnotic drug use was defined as hypnotic use for at least five days a week during a minimum of four consecutive weeks.
- •Indication: insomnia, anxiety or an undefined reason
排除标准
- •Concomitant use of multiple benzodiazepines and/or Z-drugs
- •Discontinuation of the hypnotic drug prior to enrollment
- •Estimated discharge from the hospital within 72 hours of admission
- •No command of the Dutch language
- •Severe psychiatric or neurological disease (e.g. bipolar disorder, epilepsy or dystonia) or a severe acute medication condition in the opinion of the treating physician
- •End-of-life care.
- •Study participants who died during their hospital stay were excluded from the analysis as their medication at discharge could not be evaluated. In case of any readmission, only the first admission was included in the analysis.
结局指标
主要结局
Hypnotic drug discontinuation at one month after discharge
时间窗: 1 month after discharge
Difference in hypnotic discontinuation rate between before and after group
次要结局
- Restart of hypnotics during hospital stay(From enrollment until discharge (the end of the hospital stay, on average 12 days after admission))
- Sleep quality(Upon inclusion, fourteen days after enrollment and one month after discharge)
- Safety - incidence of delirium occurence during hospital stay(From enrollment until discharge (the end of the hospital stay, on average 12 days after admission))
- Fall risk(1 month after discharge)
- Hypnotic drug use(1 and 2 weeks after enrollment and at discharge (the end of the hospital stay, on average 12 days after admission))
- Determinants for post-discharge hypnotic discontinuation(1 month after discharge)