Citation

Erwin WJ, Goodman C, Smith T. Ment. Health Clin. 2018; 8(3): 100-104.

Affiliation

Clinical Pharmacy Specialist, W.G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina.

Copyright

(Copyright © 2018, College of Psychiatric and Neurologic Pharmacists)

DOI

10.9740/mhc.2018.05.100

PMID

29955553

PMCID

PMC6007638

Abstract

INTRODUCTION: The use of benzodiazepines and sedative-hypnotics in the elderly is associated with a significant risk of delirium, falls, fractures, cognitive impairment, and motor vehicle accidents. This quality improvement project applies a direct-to-consumer intervention to an elderly veteran population to reduce the use of these medications.

METHODS: Patients aged 75 and older currently taking a benzodiazepine and/or a sedative-hypnotic were included in the project. Direct-to-consumer education intervention letters were mailed to patients within 30 days of their next appointment. Their providers were emailed a questionnaire after the patient's appointment. Providers were asked if the letter prompted a conversation regarding medication use, whether the provider initiated discussion regarding a taper, and whether a specific taper plan was developed. Medical records were reviewed to determine if a reduction in dose or discontinuation occurred.

RESULTS: Fifty-nine direct-to-consumer education letters were mailed to the patients. Follow-up questionnaires were e-mailed to 44 providers, and 27 providers responded. Twenty-two percent of patients had their benzodiazepine and/or sedative hypnotic dose reduced or discontinued after their follow-up appointment. Sixty-seven percent of veterans initiated a conversation with their provider regarding their medication with 74% of providers discussing dose reduction. Fifty-six percent of recipients developed a specific taper plan with their provider.

DISCUSSION: The data from this project suggests that direct-to-consumer patient education can reduce the exposure to benzodiazepines and sedative-hypnotics in an elderly veteran population. More data is needed on larger populations to further explore the benefit of direct-to-consumer interventions.

Language: en

Keywords

benzodiazepines; direct-to-consumer; elderly; sedative-hypnotics; veteran