OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts. INTERVENTION: Consultant pharmacist recommendations to decrease inappropriate use of sedative/hypnotics. MAIN OUTCOME MEASURE: Acceptance rates for discontinuation/tapering of the selected sedative/hypnotics. RESULTS: A total of 36 patients were enrolled in the study based on inclusion/exclusion criteria. Overall, 39 interventions were performed. Gradual dose reductions/ discontinuation of select sedative/hypnotics were accepted for 19 residents (48.7%). Of the other recommendations, 8 (20.5%) were denied and 12 (30.8%) were left unanswered. Primary reasons for denial included family refusal, satisfactory response to current dose, and requirement of increased dose as a result of worsening insomnia. CONCLUSIONS: Overall, pharmacist intervention can have a meaningful impact on reducing inappropriate sedative/ hypnotic use in the elderly population through concise, evidence-based recommendations to physicians.
OBJECTIVE: To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting. DESIGN: A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents. SETTING: Eleven regional long-term care facilities in Northeastern Tennessee. PARTICIPANTS: Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts. INTERVENTION: Consultant pharmacist recommendations to decrease inappropriate use of sedative/hypnotics. MAIN OUTCOME MEASURE: Acceptance rates for discontinuation/tapering of the selected sedative/hypnotics. RESULTS: A total of 36 patients were enrolled in the study based on inclusion/exclusion criteria. Overall, 39 interventions were performed. Gradual dose reductions/ discontinuation of select sedative/hypnotics were accepted for 19 residents (48.7%). Of the other recommendations, 8 (20.5%) were denied and 12 (30.8%) were left unanswered. Primary reasons for denial included family refusal, satisfactory response to current dose, and requirement of increased dose as a result of worsening insomnia. CONCLUSIONS: Overall, pharmacist intervention can have a meaningful impact on reducing inappropriate sedative/ hypnotic use in the elderly population through concise, evidence-based recommendations to physicians.
Authors: Daniel J Hoyle; Ivan K Bindoff; Lisa M Clinnick; Gregory M Peterson; Juanita L Westbury Journal: Drugs Aging Date: 2018-02 Impact factor: 3.923
Authors: David John Wright; Vivienne Maskrey; Annie Blyth; Nigel Norris; David P Alldred; Christine M Bond; James Desborough; Carmel M Hughes; Richard Charles Holland Journal: Int J Pharm Pract Date: 2019-11-12