Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study

BMC Geriatrics

Dominique Bonnet-Zamponi¹  Amandine Baptiste²  Lucas Zerbib³  Adrien Borowik³  Florence Tubach⁴  Christine Fernandez⁵  Patrick Hindlet⁵  Elsa Bourcier⁵ 

[1] AP-HP, Hôpital Pitié-Salpêtrière, Centre de pharmacoépidémiologie (Céphépi), INSERM, UMR 1123, CIC-P 1421;AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, Centre de pharmacoépidémiologie (Céphépi), INSERM, CIC-P 1421;Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Pharmacie;Sorbonne Université, Faculté de médecine Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, Centre de pharmacoépidémiologie (Céphépi), INSERM, UMR 1123, CIC-P 1421;Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136;

关键词: Sedative-hypnotics;    Initiation;    Older adults;    Hospitalization;    Risk factors;   

DOI  :  10.1186/s12877-018-0972-3

来源: DOAJ

【 摘 要 】

Abstract Background Sedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hospital stay of older patients, the proportion of SH renewal at discharge among these patients and to study associated risk factors. Methods We conducted a retrospective observational study in six internal medicine units and six acute geriatric units in eight hospitals (France). We included 1194 inpatients aged 65 and older without SH medications prior to hospitalization. Data were obtained from patients’ electronic pharmaceutical records. Primary outcome was the cumulative incidence of SH initiation in the study units. Secondary outcomes were the proportion of SH renewal at discharge and risk factors for SH initiation and renewal at discharge (patient characteristics, hospital organization). A Cox regression model was used to study risk factors for SH initiation. A mixed effects logistic regression was used to study risk factors for SH renewal at discharge. Results SH initiation occurred in 21.5% of participants 20 days after admission. SH renewal at discharge occurred in 38.7% of patients who had initiated it during their stay and were discharged home and in 56.0% of patients discharged to rehabilitation facilities. Neither patients’ characteristics nor hospital organization patterns was associated with SH initiation. SH initiation after the first six days after admission was associated with a lower risk of SH renewal in patients discharged to rehabilitation facilities (OR = 0.19, 95% CI: [0.04–0.80]). Conclusions Hospitalization is a period at risk for SH initiation. The implementation of interventions promoting good use of SHs is thus of first importance in hospitals. Specific attention should be paid to patients discharged to rehabilitation facilities.

【 授权许可】

Unknown