Prevalence of sedative drug use in geriatric in-patients: a multi-centre study.
OBJECTIVE
This cross-sectional study registered the prevalence of sedative drug use and withdrawal strategies in geriatric in-patients from 30 centres in nine European countries.


METHODS
We conducted a survey among young geriatricians using a standardised questionnaire on sedative drug use for more than three weeks. The study population consisted of 1972 in-patients aged 75 years or older. Acute care (620), intermediate care/rehabilitation (359), long-term care (261), terminal care (47) and nursing home (685) settings were represented. The pre-specified outcomes included the prevalence of sedative drug use; the identification of main prescribers and main reasons for prescribing and, the assessment of withdrawal policy, including psychological counselling and involvement of general practitioners.


RESULTS
Prevalence of sedative use was highest in long-term care (72%), followed by nursing homes (70%) and terminal care (59%). Geriatricians started prescribing sedatives after admission on 52% of all occasions. The main reasons for prescribing were continuation of medication taken at home (37%), sleep problems emerging after admission (26%) and post-admission worsening of existing sleep problems (20%). Most prescribers (70%) applied an active withdrawal policy. Short-term withdrawal programmes were mostly applied (57%). Most patients (60%) were psychologically counselled during withdrawal from sedatives. General practitioners were often (60%) involved in withdrawal policy.


CONCLUSIONS
The prevalence of prescription of sedative drugs in geriatric in-patients is high. Appropriate setting specific guidelines are needed to control use of sedatives in geriatric in-patients and to ensure withdrawal from these drugs whenever possible.
Petrovic
M
M
Department of Geriatrics and Gerontology, Ghent University Hospital, Ghent, Belgium. mirko.petrovic@ugent.be
Spatharakis
G
G
Conroy
S
S
Van Maeles
G
G
Moulias
S
S
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000188:drug therapy; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007297:Inpatients; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012893:Sleep Wake Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires
D006993:Hypnotics and Sedatives