Related Experiment Video
Updated: Jan 20, 2026
07:10
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
10.3K
Academic Detailing to Reduce Sedative-Hypnotic Prescribing in Older Veterans
Addison P Ragan1, Garrett B Aikens2, Mark Bounthavong3
1Department of Veterans Affairs, Atlanta Network, Duluth, GA, USA.
Journal of Pharmacy Practice
|August 27, 2019
Summary
Academic detailing significantly reduced sedative-hypnotic prescriptions, including benzodiazepines (BZDs) and BZD receptor agonists (BZD-RAs), in older veterans. This educational outreach promoted deprescribing of potentially inappropriate medications.
Area of Science:
- Geriatric pharmacotherapy
- Clinical pharmacology
- Health services research
Background:
- Sedative-hypnotics like benzodiazepines (BZDs) and BZD receptor agonists (BZD-RAs) are potentially inappropriate medications (PIMs) for older adults.
- Academic detailing is an evidence-based educational outreach strategy to promote appropriate prescribing.
Purpose of the Study:
- To assess the impact of academic detailing on sedative-hypnotic prescribing patterns among older veterans.
- To evaluate changes in benzodiazepine and BZD-RA prescriptions in a veteran population aged 75 years and older.
Main Methods:
- Retrospective analysis of prescribing data from 155 prescribers in the VA Southeast Network.
- Pre-post analysis and interrupted time series analyses (ITSAs) of prescribing trends before and after academic detailing.
- Calculation of period prevalence (prescriptions per 1000 older veterans).
Main Results:
- Benzodiazepine prevalence decreased by 23% and BZD-RA prevalence by 15%.
- New prescriptions for BZDs and BZD-RAs declined by over 50% each.
- Prescribing of alternative insomnia medications increased by 23%, with sustained effects observed post-intervention.
Conclusions:
- Academic detailing effectively reduced sedative-hypnotic prescribing in primary care and mental health settings for older veterans.
- This intervention supports deprescribing of PIMs and promotes safer medication use in geriatric populations.
Related Concept Videos
01:23Sedatives and Hypnotics: Overview
1.4K
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
1.4K
01:20Sedatives and Hypnotics Drugs: Barbiturates
963
Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
963
01:19Sedatives and Hypnotics Drugs: Benzodiazepines
795
Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
795
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
526
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
526
01:23Detailed Structure and Function of Lymph Nodes
4.5K
Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
4.5K
01:18Reducing Line Loss
370
In a three-phase circuit, line loss is an indicator of energy dissipated as heat due to the resistance of transmission lines. To address this, incorporating transformers into the system—a step-up transformer at the source and a step-down transformer at the load—is a strategic solution. Two three-phase transformers are introduced to improve this.
With a step-up transformer at the source, the voltage is increased, thereby reducing the current in the transmission lines since power loss in...
With a step-up transformer at the source, the voltage is increased, thereby reducing the current in the transmission lines since power loss in...
370