Prescription of hypnotics during hospital stay: an epidemiological study in a Swiss hospital

Details

Serval ID
serval:BIB_3D4D3F1251CD
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Title
Prescription of hypnotics during hospital stay: an epidemiological study in a Swiss hospital
Title of the conference
83. Jahresversammlung der Schweizerischen Gesellschaft für Allgemeine Innere Medizin
Author(s)
Schumacher L., Blanc A.L., Tagan D., Sautebin A., Widmer N.
Address
Basel, Schweiz, 20.-22. Mai 2015
ISBN
1661-8157
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
104
Series
Praxis
Pages
73-74
Language
english
Abstract
Background and objective: Hypnotics have been associated with many adverse effects, such as drowsiness, confusion, falls and dizziness, especially in elderly population. Moreover, chronic use can cause decreased cognitive performance and addiction. A regional prevention campaign "Hypnotic? Not necessarily needed" conducted in the Canton of Vaud, focused on this topic. This study aims to describe introduction and discharge prescription of hypnotic drugs during stay in an internal medicine ward.
Method: The study took place in a 70 bed internal medicine department of a Swiss regional hospital for a period of 3 months. Inclusion criteria were: age 18 or more, hospital stay for more than 24 hours, discernment and patient's approval. Demographic data (age, gender, diagnosis, co-morbidity) and medication data (chronic hypnotic use, hypnotic's introduction, day of introduction, drug-related problems, and administrative data) were collected.
Results: 290 patients were included. 73% of them were over 65 years old and 58% were women. 34% had a chronic use of hypnotics before hospital stay and 44% had a prescription for hypnotics after hospital stay. Hypnotics medication were introduced in 37% (n=108) of patients, mostly as required (68%). Half (52%) of hypnotics were prescribed during the first 24 hours of hospital stay and 76% of these introductions were not reassessed during hospital stay. Drugs introduced were: benzodiazepines (47%), clomethiazol (32%), benzodiazepine related drugs (11%; zolpidem, zopiclone) and other hypnotics (10%; herbal drugs, melatonin, antidepressant and antipsychotic). Different hypnotics were used depending on age: lorazepam for people < 65 years old, and clomethiazol for â0/00¥ 65 years old. Drug-drug interactions were detected in 68% of new hypnotic prescription: 87% pharmacodynamic (mutual increase of adverse reactions) and 13% pharmacokinetic (impact on drug disposition). After hospital stay, 37% (n=40) of the patients had a new hypnotic drugs on their discharge prescription compared to their preadmission treatment.
Conclusion: Introduction of a hypnotic medication happened in nearly 40% of hospitalized patients. Most of the time, physicians reassessed the new hypnotic on discharges prescriptions, one-third of hypnotics are kept at the end of the hospital stay. These prescriptions may generate chronic use and expose patients to drug- related problem (adverse effects and interactions).
Open Access
Yes
Create date
24/05/2015 20:56
Last modification date
20/08/2019 13:33
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