The impact of in hospital patient-education intervention on older people's attitudes and intention to have their benzodiazepines deprescribed: a feasibility study

Danijela Gnjidic; Hui Min Magdalene Ong; Celeste Leung; Jesse Jansen; Emily Reeve

doi:10.1177/2042098618816562

The impact of in hospital patient-education intervention on older people's attitudes and intention to have their benzodiazepines deprescribed: a feasibility study

Ther Adv Drug Saf. 2019 Jan 17:10:2042098618816562. doi: 10.1177/2042098618816562. eCollection 2019.

Authors

Danijela Gnjidic¹, Hui Min Magdalene Ong², Celeste Leung², Jesse Jansen³, Emily Reeve⁴

Affiliations

¹ Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
² Sydney Pharmacy School, Sydney, NSW, Australia.
³ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁴ Faculty of Medicine and Health, University of Sydney, NSW, Australia Geriatric Medicine Research, Dalhousie University and Nova Scotia Health Authority, NS, Canada College of Pharmacy, Dalhousie University, NS, Canada.

Abstract

Background: Long-term benzodiazepine use in the older population is common and is associated with significant harm. The provision of a patient-educational booklet during hospitalization may encourage patients to discuss review and possible deprescribing of benzodiazepine therapy with their health professionals. The aim of this study was to assess the feasibility and effect of a patient empowerment intervention in hospital inpatients on patient initiation of a discussion about deprescribing benzodiazepines versus usual care.

Methods: A feasibility interventional study using a patient-empowerment education intervention was conducted at a Sydney teaching hospital. Patients aged ⩾ 65 years, prescribed a benzodiazepine, and able to provide consent were invited to participate in the study. Participants were randomly allocated to intervention or control group (1:1). Intervention participants received the patient-empowerment booklet and control received usual care. All participants received 1-month follow-up phone interviews to assess medication and attitudinal changes.

Results: A total of 42 participants were recruited (20 intervention and 22 control). The average age was 71.5 (interquartile range: 69.0-80.3) and 54.8% were females. There was no difference in baseline characteristics between intervention and control groups (p > 0.05). At baseline, 65.0% of participants (53.0% intervention, 86.0% control) were not concerned about the potential benzodiazepine side effects. Twenty-nine participants (15 intervention and 14 control) completed 1-month follow up; 22 participants (11 intervention and 11 control) were discharged on the benzodiazepine. Among these, 13 (59.1%) had ceased benzodiazepine at 1-month follow up [46.2% (n = 6) intervention; 53.8% (n = 7) control]. In the intervention group, 33.3% (n = 5) of participants had initiated a discussion with their doctor or pharmacist about stopping the benzodiazepine compared with 35.7% (n = 5) in the control group.

Conclusion: Cessation of benzodiazepines 1 month following discharge was common. Future larger studies are required to confirm the effectiveness of providing a patient-empowerment booklet on reducing benzodiazepine use and other potentially inappropriate medications.

Keywords: acute care setting; benozidiazepines; deprescribing; patient-centred.