Pilot RCT Testing A Mailing About Sleeping Pills and Cognitive Behavioral Therapy for Insomnia: Impact on Benzodiazepines and Z-Drugs.

IF 2.6 3区 医学 Q3 GERIATRICS & GERONTOLOGY Clinical Gerontologist Pub Date : 2024-05-01 Epub Date: 2022-10-06 DOI:10.1080/07317115.2022.2130849
Selene S Mak, Cathy A Alessi, Christopher N Kaufmann, Jennifer L Martin, Michael N Mitchell, Christi Ulmer, Hillary D Lum, Michaela S McCarthy, Jason P Smith, Constance H Fung
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Abstract

Objectives: The aim is to pilot a low-touch program for reducing benzodiazepine receptor agonist (BZRA; benzodiazepines, z-drugs) prescriptions among older veterans.

Methods: 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.

Results: 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 (p-values >0.36).

Conclusions: 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.

Clinical implications: Mailing information about BZRA risks and CBTI did not affect BZRA prescriptions.

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试验性 RCT 测试 "关于安眠药和失眠认知行为疗法的邮件:对苯二氮卓类药物和 Z 类药物的影响"。
目的目的是在老年退伍军人中试行一项减少苯二氮卓受体激动剂(BZRA;苯二氮卓类,z-drugs)处方的低接触计划:试点随机对照试验包括 2,009 名年龄≥ 65 岁的退伍军人,他们在过去 18 个月中曾在退伍军人健康管理局药房(科罗拉多州或蒙大拿州)开过 BZRA 处方。活动:第 1 组是一份关于 BZRA 风险的邮寄宣传册,其中还包括一项免费的在线失眠认知行为疗法 (CBTI) 计划的相关信息。第 2 组为邮寄宣传册(与第 1 组相同)和电话强化。对照组:第三组为邮寄小册子,不含失眠治疗信息。对随访(6 个月和 12 个月)时的有效 BZRA 处方进行了测量:在逻辑回归分析中,第一或第二组(积极组)与第三组(对照组)在 6 个月和 12 个月随访时开具 BZRA 处方的几率没有显著差异,包括根据人口统计学和处方特征调整的模型(P 值大于 0.36):虽然我们没有观察到 BZRA 有效处方的差异,但这项试点研究为今后开展研究提供了指导,表明有必要采取更有力的干预措施。测试优化方案的全面试验将提供结论性结果:邮寄有关 BZRA 风险和 CBTI 的信息不会影响 BZRA 的处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Gerontologist
Clinical Gerontologist GERIATRICS & GERONTOLOGY-PSYCHIATRY
CiteScore
6.20
自引率
25.00%
发文量
90
审稿时长
>12 weeks
期刊介绍: Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including: -adjustments to changing roles- issues related to diversity and aging- family caregiving- spirituality- cognitive and psychosocial assessment- depression, anxiety, and PTSD- Alzheimer’s disease and other neurocognitive disorders- long term care- behavioral medicine in aging- rehabilitation and education for older adults. Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.
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