An attempt to influence hypnotic and sedative drug use

To assess the impact of a hospital based educational campaign on the prescription and use of hypnotic and sedative drugs.

Two three-month cross-sectional surveys were performed. The first was to obtain a baseline evaluation of hypnotic and sedative drug use within the hospital, and the second was to evaluate the success of an educational intervention designed to promote more rational prescribing and use of these drugs.

St Vincent's Hospital, Sydney, a tertiary referral hospital.

Five patients were randomly selected each day from the hospital's admission list (only psychiatric patients were excluded); 296 patients were interviewed for the first survey and 299 for the second. A minimum six-day admission was necessary for inclusion in the study. Early discharges resulted in 214 patients remaining in each survey group.

Campaigns were developed for hospital staff and for patients. A booklet and video were produced. The intervention commenced several months after the initial survey and continued throughout the second.

A change in the prescription, administration and use of hypnosedatives.

The education of staff had a considerable impact on the administration of these drugs by nursing staff and their prescribing by medical staff. The education of patients resulted in an increase in drug knowledge but had little impact on the use of hypnosedatives in hospital. However, a postal survey conducted three months after discharge from hospital showed a significant reduction (P less than 0.005) in hypnotic and sedative drug use among patients exposed to the educational campaign.

The importance of continuing education in promoting more rational drug use is highlighted by the study. But the question of the best time and place for an intervention to achieve maximum impact has yet to be answered.