Environmental scan of current strategies to decrease sedative-hypnotic drug use and promote sleep in hospital...

Area of Science:

• Geriatric Medicine
• Pharmacology
• Sleep Medicine

Background:

• Sedative-hypnotic drugs are frequently prescribed in hospitals for insomnia and anxiety.
• Guidelines recommend against their use, especially in older adults, due to significant risks like falls, fractures, and delirium.
• There is a need for evidence-based, non-pharmacologic alternatives to manage sleep issues in hospital settings.

Purpose of the Study:

• To identify publicly accessible resources aimed at reducing sedative-hypnotic drug utilization.
• To find strategies that promote better sleep in hospital patients.
• To assess the availability and nature of non-pharmacologic interventions for sleep in healthcare settings.

Main Methods:

• An extensive Google search utilizing six distinct search strategies was performed.
• Key organizational websites were also systematically searched for relevant resources.
• Inclusion criteria focused on publicly available, English-language resources from the past five years, employing non-pharmacologic methods for sleep promotion or sedative reduction.

Main Results:

• A total of 79 resources met the inclusion criteria.
• The majority focused on patient education (82.3%) and sleep hygiene strategies (39.2%).
• Other interventions included deprescribing (21.5%), relaxation training (16.5%), cognitive behavioral therapy for insomnia (11.4%), and policy development (8.9%).

Conclusions:

• Numerous resources are available to support patients and healthcare providers in decreasing sedative-hypnotic drug use and enhancing sleep quality.
• Resources specifically tailored for hospital environments were less common, though some recommended discontinuing hospital-initiated sedatives upon discharge.
• Healthcare organizations can adapt these identified resources to create effective sedative-hypnotic prescribing programs and policies.