title: Understanding and reducing the prescription of hypnotics and sedatives at the interface of hospital care and general practice: a protocol for a mixed-methods study.
abstract: Hypnotics and sedatives, especially benzodiazepines and Z-drugs, are frequently prescribed for longer periods than recommended-in spite of potential risks for patients. Any intervention to improve this situation has to take into account the interplay between different actors, interests and needs. The ultimate goal of this study is to develop-together with the professionals involved-ideas for reducing the use of hypnotics and sedatives and then to implement and evaluate adequate interventions in the hospital and at the primary and secondary care interface.
  
  
  
  The study will take place in a regional hospital in northern Germany and in some general practices in this region. We will collect data from doctors, nurses, patients and a major social health insurer to define the problem from multiple perspectives. These data will be explored and discussed with relevant stakeholders to develop interventions. The interventions will be implemented and, in a final step, evaluated. Both quantitative and qualitative data, including surveys, interviews, chart reviews and secondary analysis of social health insurance data, will be collected to obtain a full understanding of the frequency and the reasons for using hypnotics and sedatives.
  
  
  
  Approval has been granted from the ethics review committee of the University Medical Center Göttingen, Germany. Results will be disseminated to researchers, clinicians and policy makers in peer-reviewed journal articles and conference publications. One or more dissemination events will be held locally during continuous professional development events for local professionals, including (but not confined to) the study participants.
authors: Department of General Practice, University Medical Center, Göttingen, Germany Department of Health Sciences, University of Applied Sciences, Fulda, Germany.
authors: Stephanie
authors: S
authors: Heinemann
authors: Department of General Practice, University Medical Center, Göttingen, Germany.
authors: Vivien
authors: V
authors: Weiß
authors: Department of General Practice, University Medical Center, Göttingen, Germany Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany.
authors: Kati
authors: K
authors: Straube
authors: Department of Geriatrics, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany Institute of Neuropathology, University Medical Center, Göttingen, Germany.
authors: Roland
authors: R
authors: Nau
authors: German Health Insurance Medical Service (MDK) Mecklenburg-Vorpommern, Schwerin, Germany.
authors: Thomas
authors: T
authors: Grimmsmann
authors: Department of General Practice, University Medical Center, Göttingen, Germany.
authors: Wolfgang
authors: W
authors: Himmel
authors: Department of General Practice, University Medical Center, Göttingen, Germany.
authors: Eva
authors: E
authors: Hummers-Pradier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals; D006801:Humans; D006993:Hypnotics and Sedatives; D007348:Insurance, Health; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D063487:Prescription Drug Misuse / Q000517:prevention & control*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives
keywords: attitude of health personnel; continuity of patient care; drug utilization review; family practice; hospitals; hypnotics and sedatives