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J Am Geriatr Soc. 2018 Jul;66(6):1186-1189. doi: 10.1111/jgs.15300. Epub 2018 Mar 1.

EMPOWERing Hospitalized Older Adults to Deprescribe Sedative Hypnotics: A Pilot Study.

Author information

1
Department of Medicine, McGill University, Montréal, Quebec, Canada.
2
Clinical Practice Assessment Unit, McGill University Health Centre, Montréal, Quebec, Canada.
3
Division of Geriatrics, Department of Medicine, Université de Montréal, Montréal, Quebec, Canada.

Abstract

OBJECTIVES:

To distribute the EMPOWER patient education brochure and use hospitalization as an opportunity to reduce inappropriate sedatives.

DESIGN:

Participants were sequentially recruited until we achieved 30-day follow-up telephone and pharmacy records for 50 individuals. The proportion meeting the primary outcome was compared with that of a control cohort and with rates of cessation achieved in the community.

SETTING:

Fifty-two-bed medical clinical teaching unit in Montréal, Canada.

PARTICIPANTS:

Inpatients aged 65 and older who were chronic, regular sedative users.

MEASUREMENTS:

The primary outcome was short-term sustained cessation 30-days after discharge. As a secondary outcome, we compared self-reported sleep disturbance before and after the intervention.

RESULTS:

Sedatives were deprescribed in 32 of 50 (64%) participants who received the EMPOWER brochure, which was significantly higher than our historical rate of 21% (p<.001). Participants did not report significant worsening in their quality of sleep after sedative cessation.

CONCLUSION:

Hospitalized individuals are willing to deprescribe, and contact with the healthcare system provides the opportunity to initiate the process with educational brochures. This type of intervention requires few resources and is feasible and inexpensive.

KEYWORDS:

benzodiazepines; deprescribing; patient education; polypharmacy

PMID:
29492957
DOI:
10.1111/jgs.15300

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