Pharmacist-led sedative-hypnotic deprescribing in team-based primary care practice.

Area of Science:

• Pharmacology
• Geriatrics
• Primary Care

Background:

• Sedative-hypnotic (SH) medications are commonly prescribed for chronic insomnia.
• Long-term use of SH medications carries potential risks and side effects.
• Deprescribing these medications is crucial for patient safety.

Purpose of the Study:

• To evaluate an interprofessional sedative-hypnotic (SH) deprescribing program.
• To assess the program's effectiveness in a community primary care setting.
• To explore the role of Cognitive Behavioral Therapy for Insomnia (CBT-I) in SH deprescribing.

Main Methods:

• Retrospective chart review of patients referred for SH deprescribing.
• Data collected from February 2016 to June 2019.
• Analysis included patients who attempted deprescribing, with or without CBT-I.

Main Results:

• 111 patients attempted SH deprescribing; 32% achieved complete abstinence, 32% reduced dosage by ≥50%.
• Of those achieving abstinence, 72% remained abstinent at 6 months.
• While higher with CBT-I, the difference in successful tapering (abstinence or ≥50% reduction) was not statistically significant (77% vs 62%).

Conclusions:

• Pharmacist-led SH deprescribing programs can be effective, with nearly two-thirds achieving successful tapering.
• The specific contribution of CBT-I to SH deprescribing requires further investigation.
• Deprescribing efforts are vital for managing chronic insomnia and mitigating medication risks.