Geriatric Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, North Hills, California, USA.
Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Clin Gerontol. 2024 May-Jun;47(3):452-463. doi: 10.1080/07317115.2022.2130849. Epub 2022 Oct 6.
The aim is to pilot a low-touch program for reducing benzodiazepine receptor agonist (BZRA; benzodiazepines, z-drugs) prescriptions among older veterans.
Pilot randomized controlled trial consists of 2,009 veterans aged ≥ 65 years who received BZRA prescriptions from a Veterans Health Administration pharmacy (Colorado or Montana) during the prior 18 months. Active: Arm 1 was a mailed brochure about BZRA risks that also included information about a free, online cognitive behavioral therapy for the insomnia (CBTI) program. Arm 2 was a mailed brochure (same as arm 1) and telephone reinforcement call. Control: Arm 3 was a mailed brochure without insomnia treatment information. Active BZRA prescriptions at follow-up (6 and 12 months) were measured.
In logistic regression analyses, the odds of BZRA prescription at 6- and 12-month follow-ups were not significantly different for arm 1 or 2 (active) versus arm 3 (control), including models adjusted for demographics and prescription characteristics (-values >0.36).
Although we observed no differences in active BZRA prescriptions, this pilot study provides guidance for conducting a future study, indicating a need for a more potent intervention. A full-scale trial testing an optimized program would provide conclusive results.
Mailing information about BZRA risks and CBTI did not affect BZRA prescriptions.
旨在试点一项针对老年退伍军人减少苯二氮䓬类受体激动剂（BZRA；苯二氮䓬类药物、Z 药物）处方的低接触计划。
试点随机对照试验包括 2009 名年龄≥65 岁的退伍军人，他们在过去 18 个月内从退伍军人健康管理局（科罗拉多州或蒙大拿州）的药房获得 BZRA 处方。活动组 1 为邮寄有关 BZRA 风险的小册子，其中还包括有关免费在线认知行为疗法治疗失眠症（CBTI）计划的信息。活动组 2 为邮寄的小册子（与活动组 1 相同）和电话强化电话。对照组 3 为邮寄的小册子，没有失眠治疗信息。在随访（6 个月和 12 个月）时测量 BZRA 的后续处方。
在逻辑回归分析中，在 6 个月和 12 个月的随访中，与对照组 3（控制组）相比，活动组 1 或 2（活动组）的 BZRA 处方的可能性没有显著差异，包括调整了人口统计学和处方特征的模型（-值>0.36）。
尽管我们没有观察到 BZRA 处方的差异，但这项试点研究为进行未来研究提供了指导，表明需要更有效的干预措施。一项测试优化方案的全面试验将提供确凿的结果。
邮寄有关 BZRA 风险和 CBTI 的信息不会影响 BZRA 处方。
