title: Evaluating the Impact of Pharmacists on Reducing Use of Sedative/Hypnotics for Treatment of Insomnia in Long-Term Care Facility Residents.
abstract: OBJECTIVE
  To determine if pharmacist intervention can decrease the use of inappropriate sedative/hypnotics in the elderly population in the long-term care facility setting.
  
  
  METHODS
  A multicenter, prospective chart review of sedative/hypnotic use for insomnia among long-term care facility residents.
  
  
  METHODS
  Eleven regional long-term care facilities in Northeastern Tennessee.
  
  
  METHODS
  Long-term care facility residents older than 65 years of age, with confirmed insomnia diagnoses and no history of seizure or recent psychotropic gradual-dose reduction attempts.
  
  
  METHODS
  Consultant pharmacist recommendations to decrease inappropriate use of sedative/hypnotics.
  
  
  METHODS
  Acceptance rates for discontinuation/tapering of the selected sedative/hypnotics.
  
  
  RESULTS
  A total of 36 patients were enrolled in the study based on inclusion/exclusion criteria. Overall, 39 interventions were performed. Gradual dose reductions/ discontinuation of select sedative/hypnotics were accepted for 19 residents (48.7%). Of the other recommendations, 8 (20.5%) were denied and 12 (30.8%) were left unanswered. Primary reasons for denial included family refusal, satisfactory response to current dose, and requirement of increased dose as a result of worsening insomnia.
  
  
  CONCLUSIONS
  Overall, pharmacist intervention can have a meaningful impact on reducing inappropriate sedative/ hypnotic use in the elderly population through concise, evidence-based recommendations to physicians.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Gemelli
authors.forename: Katherine
authors.initials: K
authors.lastname: Yockel
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Hohmeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006707:Homes for the Aged; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D033183:Interdisciplinary Communication; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D010348:Patient Care Team; D010595:Pharmacists; D024382:Professional Role; D011368:Professional-Family Relations; D011446:Prospective Studies; D012307:Risk Factors; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013714:Tennessee
chemical_list: D006993:Hypnotics and Sedatives