Schumacher Laurence, Dobrinas Maria, Tagan Damien, Sautebin Annelore, Blanc Anne-Laure, Widmer Nicolas
Clinical Pharmacy Services, Pharmacie des Hôpitaux de l'Est Lémanique, Boulevard Paderewski 3, 1800, Vevey, Switzerland.
Internal Medicine Department, Hôpital Riviera-Chablais, Vaud-Valais, Vevey, Switzerland.
Drugs Real World Outcomes. 2017 Dec;4(4):225-234. doi: 10.1007/s40801-017-0117-6.
In recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays.
This study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication.
This observational prospective study took place in an internal medicine ward of a Swiss hospital over a period of 3 months in 2014. Demographic (age, sex, diagnosis, comorbidities) and medication data [long-term use of sedative drugs, new regular or pro re nata ('as needed') prescriptions of sedative drugs, drug-related problems] were collected. Sedative medications included: benzodiazepines, Z-drugs, antihistamines, antidepressants, neuroleptics, herbal drugs, and clomethiazole. McNemar's test was used for comparison.
Of 290 patients included, 212 (73%) were over 65 years old and 169 (58%) were women; 34% (n = 98) were using sedative drugs long term before their hospital stay, and 44% (n = 128) had a prescription for sedative drugs at discharge-a 10% increase (p < 0.05). Sedative drugs were newly prescribed to 37% (n = 108) of patients during their stay. Among these, 37% (n = 40) received a repeat prescription at discharge. Over half of the sedative drugs were prescribed within 24 h of admission. Drug-related problems were detected in 76% of new prescriptions, of which 90% were drug-drug interactions.
This study showed that hospital stays increased the proportion of patients who were prescribed a sedative drug at discharge by 10% (absolute increase). These prescriptions may generate long-term use and expose patients to drug-related problems. Promoting alternative approaches for managing insomnia are recommended.
近年来，镇静药物的处方数量显著增加，其长期使用情况亦是如此。此外，镇静药物的使用常常在住院期间开始。
本研究旨在描述住院期间镇静药物的新处方情况，并评估其作为出院用药的持续使用情况。
这项观察性前瞻性研究于2014年在瑞士一家医院的内科病房进行，为期3个月。收集了人口统计学数据（年龄、性别、诊断、合并症）和用药数据[镇静药物的长期使用情况、镇静药物的新的常规或必要时（“按需”）处方、药物相关问题]。镇静药物包括：苯二氮䓬类、Z类药物、抗组胺药、抗抑郁药、抗精神病药、草药和氯美噻唑。采用麦克尼马尔检验进行比较。
纳入的290例患者中，212例（73%）年龄超过65岁，169例（58%）为女性；34%（n = 98）在住院前长期使用镇静药物，44%（n = 128）在出院时有镇静药物处方，增加了10%（p < 0.05）。37%（n = 108）的患者在住院期间新开具了镇静药物处方。其中，37%（n = 40）在出院时获得了重复处方。超过一半的镇静药物在入院后24小时内开具。76%的新处方中检测到药物相关问题，其中90%为药物相互作用。
本研究表明，住院使出院时开具镇静药物处方的患者比例增加了10%（绝对增加）。这些处方可能导致长期用药，并使患者面临药物相关问题。建议推广管理失眠的替代方法。
