A drug use evaluation of bedtime sedation in geriatric patients

A pilot study was designed to assess the feasibility of a shared regional drug use evaluation (DUE) program involving patients. A retrospective DUE on the use of benzodiazepines, chloral hydrate and neuroleptics for bedtime sedation was performed on geriatric patient populations from two hospitals. Regional program staff coordinated the DUE, including development of the criteria and chart review. The participating Pharmacy departments performed the internal administrative and Pharmacy and Therapeutics committee communications. Forty patient charts from two sites were reviewed. The DUE results indicated different rates of drug use and discontinuation of therapy between the two geriatric patient populations. The overall rates of inappropriate drug use were similar. One undesirable clinical outcome occurred. Benzodiazepine use for more than 30 days was high in both groups. Identification of the justification for drug use, dosage reduction and drug discontinuation did not occur in the majority of patients. The pilot study identified areas where use of bedtime sedation could be improved, and allowed development of DUE criteria for future evaluation.