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

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 66; no. 6; pp. 1186 - 1189
• Main Authors: Wilson, Marnie Goodwin, Lee, Todd C., Hass, Aaron, Tannenbaum, Cara, McDonald, Emily G.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2018
• Subjects: Anesthesia; Benzodiazepines; Brochures; deprescribing; Empowerment; Hypnotics; Older people; patient education; polypharmacy; Sedatives; Sleep; benzodiazepines; deprescribing; patient education; polypharmacy
• DOI: 10.1111/jgs.15300
• ISSN: 0002-8614

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.