Reducing the use of sleep-inducing drugs during hospitalisation by a multi-faceted intervention: a pilot study

2022 | journal article; research paper. A publication of Göttingen

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​Reducing the use of sleep-inducing drugs during hospitalisation by a multi-faceted intervention: a pilot study​
Klemperer, J.; Himmel, W. ; Heinemann, S. ; Hummers, E.   & Nau, R. ​ (2022) 
European Journal of Hospital PharmacyOnline ahead of print pp. ejhpharm-2021-003097​.​ DOI: 

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Klemperer, Jonas; Himmel, Wolfgang ; Heinemann, Stephanie ; Hummers, Eva ; Nau, Roland 
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.
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European Journal of Hospital Pharmacy 
Die Initiative Schlaffreundliches Krankenhaus 
Institut für Allgemeinmedizin 
benzodiazepines, Z-drugs, hospitalisation, multi-faceted intervention, quality of health care, sleep medicine
German Ministry of Health



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