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Environmental scan of current strategies to decrease sedative-hypnotic drug use and promote sleep in hospital patients

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Abstract

Background

Sedative-hypnotic drugs are often initiated in hospital to manage insomnia and anxiety. Guidelines discourage their use, particularly in older adults, due to risks of falls, fractures, and delirium.

Aim

To identify publicly available resources to decrease the use of sedative-hypnotic drugs and promote sleep in hospital.

Method

An advanced Google search with 6 search strategies was conducted. Key websites were also identified and searched. Hospital- or community-based resources using non-pharmacologic measures to reduce sedative-hypnotic drug use and/or to promote sleep were included if they were publicly available in English within the past 5 years. Full text screening and data extraction was performed independently by 2 reviewers; a third reviewer resolved disagreements by consensus.

Results

A total of 79 resources met inclusion criteria, with 65 (82.3%) providing education and 31 (39.2%) describing sleep hygiene strategies. Other resources included deprescribing (17, 21.5%), relaxation training (13, 16.5%), cognitive behavioural therapy for insomnia (9, 11.4%), and policies (7, 8.9%). The resources primarily targeted patients (59, 74.7%) followed by healthcare providers (9, 11.4%). There were 9 resources (11.4%) that applied to both community and hospital settings, and another 2 (2.5%) designed specifically for hospital.

Conclusion

Many resources were available to patients and healthcare providers to reduce inappropriate or ineffective use of sedative-hypnotic drugs and promote better sleep. Specific resources for the hospital setting were infrequent and recommended that clinicians stop hospital-initiated sedatives when patients are discharged. Identified resources can be adapted by healthcare organizations to develop sedative-hypnotic prescribing programs and policies.

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Acknowledgements

The authors thank Kristy Hancock, MSSU Evidence Synthesis Coordinator, for assistance with the Google search.

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Funding has been received from the Drug Evaluation Alliance of Nova Scotia.

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  1. Nova Scotia Health Authority, 1276 South Park Street, Halifax, Nova Scotia, B3H 2Y9, Canada

    Heather L. Neville

  2. College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada

    Jenna Shaw, Carter VanIderstine & Jennifer E. Isenor

  3. Nova Scotia Health, Halifax, Nova Scotia, Canada

    Jenna Shaw, Carter VanIderstine, Sarah Burgess, Marci Dearing, Kent Toombs & Susan K. Bowles

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Neville, H.L., Shaw, J., VanIderstine, C. et al. Environmental scan of current strategies to decrease sedative-hypnotic drug use and promote sleep in hospital patients. Int J Clin Pharm 45, 1062–1073 (2023). https://doi.org/10.1007/s11096-023-01632-7

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