Prescription of Sedative Drugs During Hospital Stay: A Swiss Prospective Study.

Drugs Real World Outcomes

Clinical Pharmacy Services, Pharmacie des Hôpitaux de l'Est Lémanique, Boulevard Paderewski 3, 1800, Vevey, Switzerland.

Published: December 2017

Background: In recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays.

Objectives: This study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication.

Methods: This observational prospective study took place in an internal medicine ward of a Swiss hospital over a period of 3 months in 2014. Demographic (age, sex, diagnosis, comorbidities) and medication data [long-term use of sedative drugs, new regular or pro re nata ('as needed') prescriptions of sedative drugs, drug-related problems] were collected. Sedative medications included: benzodiazepines, Z-drugs, antihistamines, antidepressants, neuroleptics, herbal drugs, and clomethiazole. McNemar's test was used for comparison.

Results: Of 290 patients included, 212 (73%) were over 65 years old and 169 (58%) were women; 34% (n = 98) were using sedative drugs long term before their hospital stay, and 44% (n = 128) had a prescription for sedative drugs at discharge-a 10% increase (p < 0.05). Sedative drugs were newly prescribed to 37% (n = 108) of patients during their stay. Among these, 37% (n = 40) received a repeat prescription at discharge. Over half of the sedative drugs were prescribed within 24 h of admission. Drug-related problems were detected in 76% of new prescriptions, of which 90% were drug-drug interactions.

Conclusion: This study showed that hospital stays increased the proportion of patients who were prescribed a sedative drug at discharge by 10% (absolute increase). These prescriptions may generate long-term use and expose patients to drug-related problems. Promoting alternative approaches for managing insomnia are recommended.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684046PMC
http://dx.doi.org/10.1007/s40801-017-0117-6DOI Listing

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