Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study
Abstract Background Sedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hos...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-018-0972-3 |
| _version_ | 1818550686528307200 |
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| author | Elsa Bourcier Amandine Baptiste Adrien Borowik Lucas Zerbib Dominique Bonnet-Zamponi Florence Tubach Christine Fernandez Patrick Hindlet |
| author_facet | Elsa Bourcier Amandine Baptiste Adrien Borowik Lucas Zerbib Dominique Bonnet-Zamponi Florence Tubach Christine Fernandez Patrick Hindlet |
| author_sort | Elsa Bourcier |
| collection | DOAJ |
| description | Abstract Background Sedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hospital stay of older patients, the proportion of SH renewal at discharge among these patients and to study associated risk factors. Methods We conducted a retrospective observational study in six internal medicine units and six acute geriatric units in eight hospitals (France). We included 1194 inpatients aged 65 and older without SH medications prior to hospitalization. Data were obtained from patients’ electronic pharmaceutical records. Primary outcome was the cumulative incidence of SH initiation in the study units. Secondary outcomes were the proportion of SH renewal at discharge and risk factors for SH initiation and renewal at discharge (patient characteristics, hospital organization). A Cox regression model was used to study risk factors for SH initiation. A mixed effects logistic regression was used to study risk factors for SH renewal at discharge. Results SH initiation occurred in 21.5% of participants 20 days after admission. SH renewal at discharge occurred in 38.7% of patients who had initiated it during their stay and were discharged home and in 56.0% of patients discharged to rehabilitation facilities. Neither patients’ characteristics nor hospital organization patterns was associated with SH initiation. SH initiation after the first six days after admission was associated with a lower risk of SH renewal in patients discharged to rehabilitation facilities (OR = 0.19, 95% CI: [0.04–0.80]). Conclusions Hospitalization is a period at risk for SH initiation. The implementation of interventions promoting good use of SHs is thus of first importance in hospitals. Specific attention should be paid to patients discharged to rehabilitation facilities. |
| first_indexed | 2024-12-12T08:49:48Z |
| format | Article |
| id | doaj.art-b0f926d0c179448880fa97993da8588c |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T08:49:48Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-b0f926d0c179448880fa97993da8588c2022-12-22T00:30:17ZengBMCBMC Geriatrics1471-23182018-11-011811810.1186/s12877-018-0972-3Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational studyElsa Bourcier0Amandine Baptiste1Adrien Borowik2Lucas Zerbib3Dominique Bonnet-Zamponi4Florence Tubach5Christine Fernandez6Patrick Hindlet7Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, Centre de pharmacoépidémiologie (Céphépi), INSERM, CIC-P 1421Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Service de PharmacieAssistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Service de PharmacieAP-HP, Hôpital Pitié-Salpêtrière, Centre de pharmacoépidémiologie (Céphépi), INSERM, UMR 1123, CIC-P 1421Sorbonne Université, Faculté de médecine Sorbonne Université, AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, Centre de pharmacoépidémiologie (Céphépi), INSERM, UMR 1123, CIC-P 1421Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique, IPLESP UMR-S1136Abstract Background Sedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hospital stay of older patients, the proportion of SH renewal at discharge among these patients and to study associated risk factors. Methods We conducted a retrospective observational study in six internal medicine units and six acute geriatric units in eight hospitals (France). We included 1194 inpatients aged 65 and older without SH medications prior to hospitalization. Data were obtained from patients’ electronic pharmaceutical records. Primary outcome was the cumulative incidence of SH initiation in the study units. Secondary outcomes were the proportion of SH renewal at discharge and risk factors for SH initiation and renewal at discharge (patient characteristics, hospital organization). A Cox regression model was used to study risk factors for SH initiation. A mixed effects logistic regression was used to study risk factors for SH renewal at discharge. Results SH initiation occurred in 21.5% of participants 20 days after admission. SH renewal at discharge occurred in 38.7% of patients who had initiated it during their stay and were discharged home and in 56.0% of patients discharged to rehabilitation facilities. Neither patients’ characteristics nor hospital organization patterns was associated with SH initiation. SH initiation after the first six days after admission was associated with a lower risk of SH renewal in patients discharged to rehabilitation facilities (OR = 0.19, 95% CI: [0.04–0.80]). Conclusions Hospitalization is a period at risk for SH initiation. The implementation of interventions promoting good use of SHs is thus of first importance in hospitals. Specific attention should be paid to patients discharged to rehabilitation facilities.http://link.springer.com/article/10.1186/s12877-018-0972-3Sedative-hypnoticsInitiationOlder adultsHospitalizationRisk factors |
| spellingShingle | Elsa Bourcier Amandine Baptiste Adrien Borowik Lucas Zerbib Dominique Bonnet-Zamponi Florence Tubach Christine Fernandez Patrick Hindlet Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study BMC Geriatrics Sedative-hypnotics Initiation Older adults Hospitalization Risk factors |
| title | Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study |
| title_full | Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study |
| title_fullStr | Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study |
| title_full_unstemmed | Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study |
| title_short | Sedative-hypnotic initiation and renewal at discharge in hospitalized older patients: an observational study |
| title_sort | sedative hypnotic initiation and renewal at discharge in hospitalized older patients an observational study |
| topic | Sedative-hypnotics Initiation Older adults Hospitalization Risk factors |
| url | http://link.springer.com/article/10.1186/s12877-018-0972-3 |
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