Pub Date : 2024-05-01DOI: 10.1016/j.sapharm.2024.05.005
Stephanie Ferreira Botelho, Laís Lessa Neiva Pantuzza, Adriano Max Moreira Reis
{"title":"Development, content validation and standardization of an adult patient prioritization tool for hospital clinical pharmacy services.","authors":"Stephanie Ferreira Botelho, Laís Lessa Neiva Pantuzza, Adriano Max Moreira Reis","doi":"10.1016/j.sapharm.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.sapharm.2024.05.005","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-16DOI: 10.1101/2022.05.16.22275134
Megan E Dowd, E. Tang, Kurlya T Yan, K. McCall, B. Piper
Background: Morphine is one of the oldest, most commonly prescribed, and widely used opioids in the United States (US). The potent analgesic properties of morphine have also been associated with the increase in misuse, addiction and opioid-related deaths in the US since the 1990s. Despite federal regulations, population-adjusted prescription opioid distribution varies markedly between states. The objective of this study was to describe the temporal pattern of morphine distribution nationally and between states. Methods: Drug weight and population data were obtained from Report 5 of the US Drug Enforcement Administrations Automation of Reports and Consolidated Orders System (ARCOS) to characterize patterns in the distribution of morphine from 2012 to 2020. Morphine distribution amounts were separated by state and business type and corrected for population. States outside a 95% confidence interval relative to the national average were considered statistically significant. Results: Pharmacies and hospitals distributed 24,200 kilograms of morphine in 2012. Tennessee (180.2 mg/person) was 4.7-fold higher than Texas (39.4 mg/person). National distribution decreased 56.4% to 10,723 kilograms in 2020. Tennessee (56.4 mg/person) was 3.8-fold higher than the District of Columbia (15.0 mg/person). The decline in Illinois (-40.9%) was significantly less than the national average (-56.8%) while that of Oregon (-71.1%) and Arizona (-70.4%) were significantly higher. Hospital decrease (-72.7%) from 2012-2020 was larger than that of pharmacies (-56.12%). Conclusions: The national 56% decline in the distribution of morphine in the last decade may be attributable to prioritization of the opioid crisis as a public concern, including subsequent growth of opioid misuse and treatment programs and decreased production quotas for opioids, including morphine. This decline also coincides with the national shortage of parenteral opioids resulting in greater prescriptions of alternative opioids such as nalbuphine and buprenorphine. Further research is necessary to understand the persistent four-fold regional difference between states.
{"title":"Reductions and pronounced regional differences in morphine distribution in the United States","authors":"Megan E Dowd, E. Tang, Kurlya T Yan, K. McCall, B. Piper","doi":"10.1101/2022.05.16.22275134","DOIUrl":"https://doi.org/10.1101/2022.05.16.22275134","url":null,"abstract":"Background: Morphine is one of the oldest, most commonly prescribed, and widely used opioids in the United States (US). The potent analgesic properties of morphine have also been associated with the increase in misuse, addiction and opioid-related deaths in the US since the 1990s. Despite federal regulations, population-adjusted prescription opioid distribution varies markedly between states. The objective of this study was to describe the temporal pattern of morphine distribution nationally and between states. Methods: Drug weight and population data were obtained from Report 5 of the US Drug Enforcement Administrations Automation of Reports and Consolidated Orders System (ARCOS) to characterize patterns in the distribution of morphine from 2012 to 2020. Morphine distribution amounts were separated by state and business type and corrected for population. States outside a 95% confidence interval relative to the national average were considered statistically significant. Results: Pharmacies and hospitals distributed 24,200 kilograms of morphine in 2012. Tennessee (180.2 mg/person) was 4.7-fold higher than Texas (39.4 mg/person). National distribution decreased 56.4% to 10,723 kilograms in 2020. Tennessee (56.4 mg/person) was 3.8-fold higher than the District of Columbia (15.0 mg/person). The decline in Illinois (-40.9%) was significantly less than the national average (-56.8%) while that of Oregon (-71.1%) and Arizona (-70.4%) were significantly higher. Hospital decrease (-72.7%) from 2012-2020 was larger than that of pharmacies (-56.12%). Conclusions: The national 56% decline in the distribution of morphine in the last decade may be attributable to prioritization of the opioid crisis as a public concern, including subsequent growth of opioid misuse and treatment programs and decreased production quotas for opioids, including morphine. This decline also coincides with the national shortage of parenteral opioids resulting in greater prescriptions of alternative opioids such as nalbuphine and buprenorphine. Further research is necessary to understand the persistent four-fold regional difference between states.","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"83 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123232682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01DOI: 10.1016/j.sapharm.2022.04.005
Tamara Koehler, F. Velthuis, E. Helmich, M. Westerman, D. Jaarsma
{"title":"Implementing the pharmacy technician role in existing pharmacy settings: Stakeholders views of barriers and facilitators.","authors":"Tamara Koehler, F. Velthuis, E. Helmich, M. Westerman, D. Jaarsma","doi":"10.1016/j.sapharm.2022.04.005","DOIUrl":"https://doi.org/10.1016/j.sapharm.2022.04.005","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120780669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1016/j.sapharm.2022.03.003
Kadesha A. James, Lauren Cadel, S. Hitzig, S. Guilcher
{"title":"Patient-reported outcome measures for medication-related quality of life: A scoping review.","authors":"Kadesha A. James, Lauren Cadel, S. Hitzig, S. Guilcher","doi":"10.1016/j.sapharm.2022.03.003","DOIUrl":"https://doi.org/10.1016/j.sapharm.2022.03.003","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118570144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-27DOI: 10.1101/2020.07.24.20161711
Seán Coll, M. Walsh, T. Fahey, F. Moriarty
Objective: To examine factors associated with continuation of hospital-initiated benzodiazepine receptor agonists (BZRAs) among adults aged [≥]65 years, specifically instructions on hospital discharge summaries. Methods: This retrospective cohort study involved anonymised electronic record data on prescribing and hospitalisations for 38,229 patients aged [≥]65 from forty-four GP practices in Ireland 2011-2016. BZRA initiations were identified among patients with no BZRA prescription in the previous 12 months. Multivariate regression examined whether instructions on discharge messages for hospital-initiated BZRA prescriptions was associated with continuation after discharge in primary care and time to discontinuation. Results: Most BZRA initiations occurred in primary care, however the rate of hospital-initiated BZRAs was higher. Almost 60% of 418 hospital initiations had some BZRA instructions (e.g. duration) on the discharge summary. Approximately 40% (n=166) were continued in primary care. Lower age, being prescribed a Z-drug or great number of medicines were associated with higher risk of continuation. Of those continued in primary care, in 98 cases (59.6%) the BZRA was discontinued during follow-up (after a mean 184 days). Presence of instructions was associated with higher likelihood of discontinuation (hazard ratio 1.67, 95%CI 1.09-2.55). Conclusions: Improved communication to GPs after hospital discharge may be important in avoiding long-term BZRA use.
{"title":"Hospital initiation of benzodiazepines and Z-drugs in older adults and discontinuation in primary care","authors":"Seán Coll, M. Walsh, T. Fahey, F. Moriarty","doi":"10.1101/2020.07.24.20161711","DOIUrl":"https://doi.org/10.1101/2020.07.24.20161711","url":null,"abstract":"Objective: To examine factors associated with continuation of hospital-initiated benzodiazepine receptor agonists (BZRAs) among adults aged [≥]65 years, specifically instructions on hospital discharge summaries. Methods: This retrospective cohort study involved anonymised electronic record data on prescribing and hospitalisations for 38,229 patients aged [≥]65 from forty-four GP practices in Ireland 2011-2016. BZRA initiations were identified among patients with no BZRA prescription in the previous 12 months. Multivariate regression examined whether instructions on discharge messages for hospital-initiated BZRA prescriptions was associated with continuation after discharge in primary care and time to discontinuation. Results: Most BZRA initiations occurred in primary care, however the rate of hospital-initiated BZRAs was higher. Almost 60% of 418 hospital initiations had some BZRA instructions (e.g. duration) on the discharge summary. Approximately 40% (n=166) were continued in primary care. Lower age, being prescribed a Z-drug or great number of medicines were associated with higher risk of continuation. Of those continued in primary care, in 98 cases (59.6%) the BZRA was discontinued during follow-up (after a mean 184 days). Presence of instructions was associated with higher likelihood of discontinuation (hazard ratio 1.67, 95%CI 1.09-2.55). Conclusions: Improved communication to GPs after hospital discharge may be important in avoiding long-term BZRA use.","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115727442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-23DOI: 10.1016/j.sapharm.2020.07.0 13
Svenja Zonneveld, V. Versace, I. Krass, R. Clark, S. Shih, Suzan Detert Oude Weme, K. M. Mc Namara
{"title":"The Inverse Care Law might not apply to preventative health services in community pharmacy.","authors":"Svenja Zonneveld, V. Versace, I. Krass, R. Clark, S. Shih, Suzan Detert Oude Weme, K. M. Mc Namara","doi":"10.1016/j.sapharm.2020.07.0 13","DOIUrl":"https://doi.org/10.1016/j.sapharm.2020.07.0 13","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"418 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114120707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.sapharm.2019.10.002
Kyrillos Guirguis
{"title":"Prescribed heart failure pharmacotherapy: How closely do GPs adhere to treatment guidelines.","authors":"Kyrillos Guirguis","doi":"10.1016/j.sapharm.2019.10.002","DOIUrl":"https://doi.org/10.1016/j.sapharm.2019.10.002","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"173 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117424500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.sapharm.2019.10.009
Christine Lee, Christopher O. St. Clair, Cdr Christine Merenda, Capt Richardae Araojo, S. Ray, Derrick Beasley, Radm Denise Hinton
{"title":"Assessment of public and patient online comments in social media and food and drug administration archival data. A pilot qualitative analysis.","authors":"Christine Lee, Christopher O. St. Clair, Cdr Christine Merenda, Capt Richardae Araojo, S. Ray, Derrick Beasley, Radm Denise Hinton","doi":"10.1016/j.sapharm.2019.10.009","DOIUrl":"https://doi.org/10.1016/j.sapharm.2019.10.009","url":null,"abstract":"","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"69 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118977152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The Quadruple Aim recognizes that caring for the healthcare employee is necessary to optimize patient outcomes and health system performance. Although previous research has assessed pharmacists' workload, this study is the first to describe pharmacist occupational fatigue-a characteristic of excessive workload that inhibits workers' abilities to function at normal capacity. OBJECTIVE (s): The purpose of this study was to describe occupational fatigue in pharmacists using exploratory factor analysis (EFA)-assessing whether dimensional structures used to describe occupational fatigue in other health professions fit pharmacist perceptions. METHODS A model was created to conceptualize two "fatigue" domains found in the literature-physical fatigue (ex. Physical discomfort) and mental fatigue (ex. trouble thinking clearly). These domains were operationalized and used to create a survey that was distributed to licensed pharmacists at a conference. An EFA was conducted to identify the key domains underlying pharmacist perceptions of fatigue. RESULTS A total of 283 surveys were distributed, and 115 were returned and useable. Respondents were primarily white, female, and worked 9.5 h-per-day on average. The EFA suggested a statistically significant two-factor model (Χ2 9.73, p = 0.28), which included physical fatigue (α = 0.87) and mental fatigue (α = 0.82) dimensions. CONCLUSIONS The EFA yielded a structure similar to what was anticipated from the literature. While working, pharmacists may not be aware of fatigue related short-cuts or lapses that pose risks to patient safety. This study is just the first step in promoting systematic interventions to prevent or cope with fatigue and prevent the patient, pharmacist, and institutional outcomes.
背景:“四重目标”认识到，照顾医疗保健员工是优化患者治疗结果和卫生系统绩效的必要条件。虽然以前的研究已经评估了药剂师的工作量，但本研究是第一次描述药剂师的职业疲劳-一种过度工作量的特征，抑制了工人以正常能力工作的能力。目的:本研究的目的是使用探索性因素分析(EFA)来描述药剂师的职业疲劳-评估用于描述其他卫生专业职业疲劳的维度结构是否符合药剂师的看法。方法建立一个模型，将文献中发现的两个“疲劳”领域——身体疲劳(如身体不适)和精神疲劳(如思维障碍)概念化。这些领域被操作并用于创建一项调查，该调查在会议上分发给有执照的药剂师。进行了全民教育，以确定关键领域的药剂师疲劳的看法。结果共发放问卷283份，回收有效问卷115份。受访者主要是白人女性，平均每天工作9.5小时。EFA显示双因素模型具有统计学意义(Χ2 9.73, p = 0.28)，其中包括身体疲劳(α = 0.87)和精神疲劳(α = 0.82)两个维度。结论:EFA产生的结构与文献中预期的相似。在工作时，药剂师可能没有意识到与疲劳相关的捷径或失误会对患者安全构成风险。这项研究只是促进系统干预的第一步，以预防或应对疲劳，防止患者，药剂师和机构的结果。
{"title":"Operationalizing occupational fatigue in pharmacists: An exploratory factor analysis.","authors":"Taylor L. Watterson, K. Look, L. Steege, M. Chui","doi":"10.1101/19008169","DOIUrl":"https://doi.org/10.1101/19008169","url":null,"abstract":"BACKGROUND\u0000The Quadruple Aim recognizes that caring for the healthcare employee is necessary to optimize patient outcomes and health system performance. Although previous research has assessed pharmacists' workload, this study is the first to describe pharmacist occupational fatigue-a characteristic of excessive workload that inhibits workers' abilities to function at normal capacity.\u0000\u0000\u0000OBJECTIVE\u0000(s): The purpose of this study was to describe occupational fatigue in pharmacists using exploratory factor analysis (EFA)-assessing whether dimensional structures used to describe occupational fatigue in other health professions fit pharmacist perceptions.\u0000\u0000\u0000METHODS\u0000A model was created to conceptualize two \"fatigue\" domains found in the literature-physical fatigue (ex. Physical discomfort) and mental fatigue (ex. trouble thinking clearly). These domains were operationalized and used to create a survey that was distributed to licensed pharmacists at a conference. An EFA was conducted to identify the key domains underlying pharmacist perceptions of fatigue.\u0000\u0000\u0000RESULTS\u0000A total of 283 surveys were distributed, and 115 were returned and useable. Respondents were primarily white, female, and worked 9.5 h-per-day on average. The EFA suggested a statistically significant two-factor model (Χ2 9.73, p = 0.28), which included physical fatigue (α = 0.87) and mental fatigue (α = 0.82) dimensions.\u0000\u0000\u0000CONCLUSIONS\u0000The EFA yielded a structure similar to what was anticipated from the literature. While working, pharmacists may not be aware of fatigue related short-cuts or lapses that pose risks to patient safety. This study is just the first step in promoting systematic interventions to prevent or cope with fatigue and prevent the patient, pharmacist, and institutional outcomes.","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115722084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-05-11DOI: 10.21203/rs.3.rs-88543/v1
Heather L Neville, Courtney Granter, Pegah Adibi, J. Belliveau, J. Isenor, S. Bowles
BACKGROUND Benzodiazepines and sedative-hypnotic drugs (BZD/SHD) are commonly utilized in the acute care setting for insomnia and anxiety and are associated with cognitive impairment, falls, and fractures. Interventions to reduce use of BZD/SHD in hospitals are not well characterized. OBJECTIVE The objective was to conduct a scoping review to identify and characterize interventions to reduce the use of BZD/SHD by adults in the acute care setting. METHODS English language studies and abstracts that described an intervention to reduce BZD/SHD in adult hospital patients were included. Six databases (PubMed, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science) were searched up to July 2018 and updated to February 3, 2021. The grey literature (Opengrey, Grey Matters, Google Advanced) was searched up to July 2018. Titles and abstracts were screened and full-text articles were reviewed and charted by three independent reviewers. Stakeholders were consulted to inform the scoping review and collect perspectives on the findings. RESULTS There were 13,046 records identified and 43 studies included. The most common study designs were uncontrolled before and after (23/43, 53.5%) and randomized controlled trials (7/43, 16.3%). The majority of studies tested a single intervention (32/43, 74.4%) such as education, deprescribing, relaxation training and sleep protocols. Patients were frequently the target of relaxation training and behavior change interventions; while sleep protocols, multifaceted interventions, education and deprescribing were usually directed at healthcare providers, either alone or in combination with patients. Most studies reported positive results in decreasing BZD/SHD use (27/43, 62.8%). CONCLUSIONS The scoping review found a variety of interventions to decrease the utilization of BZD/SHD in hospitals. Multifaceted interventions aimed at patients and healthcare providers that include a combination of education, sleep protocols, and deprescribing may support reductions in BZD/SHD use. Stakeholders also recommended policy and system changes such as computer alerts due to feasibility and workload.
背景:苯二氮卓类药物和镇静催眠药物(BZD/SHD)通常用于失眠和焦虑的急性护理环境，并与认知障碍、跌倒和骨折有关。在医院减少BZD/SHD使用的干预措施没有很好地描述。目的:目的是进行范围审查，以确定和表征干预措施，以减少急性护理环境中成人BZD/SHD的使用。方法纳入描述降低成人医院患者BZD/SHD干预措施的英文研究和摘要。六个数据库(PubMed, EMBASE, CINAHL, PsycINFO, Scopus和Web of Science)被检索到2018年7月，并更新到2021年2月3日。灰色文献(Opengrey, grey Matters, Google Advanced)被搜索到2018年7月。题目和摘要经过筛选，全文文章由三名独立审稿人审阅和绘制图表。咨询了利益相关者，为范围审查提供信息，并收集了对调查结果的看法。结果共纳入13046份记录和43项研究。最常见的研究设计是前后无对照试验(23/43,53.5%)和随机对照试验(7/43,16.3%)。大多数研究测试了单一干预(32/43,74.4%)，如教育、处方、放松训练和睡眠协议。患者经常成为放松训练和行为改变干预的目标;而睡眠协议、多方面干预、教育和处方处方通常是针对医疗保健提供者的，要么单独实施，要么与患者联合实施。大多数研究报告了BZD/SHD使用减少的积极结果(27/43,62.8%)。结论本研究发现多种干预措施可降低BZD/SHD在医院的使用率。针对患者和医疗保健提供者的多方面干预措施，包括教育、睡眠协议和处方处方的结合，可能有助于减少BZD/SHD的使用。由于可行性和工作量，利益相关者还建议进行政策和系统更改，例如计算机警报。
{"title":"Interventions to reduce benzodiazepine and sedative-hypnotic drug use in acute care hospitals: A scoping review.","authors":"Heather L Neville, Courtney Granter, Pegah Adibi, J. Belliveau, J. Isenor, S. Bowles","doi":"10.21203/rs.3.rs-88543/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-88543/v1","url":null,"abstract":"BACKGROUND\u0000Benzodiazepines and sedative-hypnotic drugs (BZD/SHD) are commonly utilized in the acute care setting for insomnia and anxiety and are associated with cognitive impairment, falls, and fractures. Interventions to reduce use of BZD/SHD in hospitals are not well characterized.\u0000\u0000\u0000OBJECTIVE\u0000The objective was to conduct a scoping review to identify and characterize interventions to reduce the use of BZD/SHD by adults in the acute care setting.\u0000\u0000\u0000METHODS\u0000English language studies and abstracts that described an intervention to reduce BZD/SHD in adult hospital patients were included. Six databases (PubMed, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science) were searched up to July 2018 and updated to February 3, 2021. The grey literature (Opengrey, Grey Matters, Google Advanced) was searched up to July 2018. Titles and abstracts were screened and full-text articles were reviewed and charted by three independent reviewers. Stakeholders were consulted to inform the scoping review and collect perspectives on the findings.\u0000\u0000\u0000RESULTS\u0000There were 13,046 records identified and 43 studies included. The most common study designs were uncontrolled before and after (23/43, 53.5%) and randomized controlled trials (7/43, 16.3%). The majority of studies tested a single intervention (32/43, 74.4%) such as education, deprescribing, relaxation training and sleep protocols. Patients were frequently the target of relaxation training and behavior change interventions; while sleep protocols, multifaceted interventions, education and deprescribing were usually directed at healthcare providers, either alone or in combination with patients. Most studies reported positive results in decreasing BZD/SHD use (27/43, 62.8%).\u0000\u0000\u0000CONCLUSIONS\u0000The scoping review found a variety of interventions to decrease the utilization of BZD/SHD in hospitals. Multifaceted interventions aimed at patients and healthcare providers that include a combination of education, sleep protocols, and deprescribing may support reductions in BZD/SHD use. Stakeholders also recommended policy and system changes such as computer alerts due to feasibility and workload.","PeriodicalId":187352,"journal":{"name":"Research in social & administrative pharmacy : RSAP","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128950689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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