Brief Intervention as a Method to Reduce Z-Hypnotic Use by Older Adults: Feasibility Case Series

Area of Science:

• Gerontology
• Pharmacology
• Behavioral Science

Background:

• Z-hypnotics are commonly prescribed for insomnia in older adults but carry risks of adverse events and dependence.
• Despite guidelines, inappropriate long-term z-hypnotic use persists in this vulnerable population.
• Previous interventions focused on prescribers, leaving individually focused methods less studied.

Purpose of the Study:

• To design and test the feasibility and acceptability of a brief intervention (BI) tailored for older adults misusing z-hypnotics.
• To optimize this BI for a future randomized controlled trial (RCT) assessing its effectiveness.

Main Methods:

• A feasibility case series involving 5 older adults (≥65 years) with long-term z-hypnotic use.
• The BI included risk information and individualized advice for reducing sleep medication, emphasizing shared decision-making.
• Data collected via qualitative and quantitative measures from participants, physicians, and investigators.

Main Results:

• The 15-minute BI was completed by all participants and deemed acceptable by them and intervening physicians.
• Two participants completely ceased z-hypnotic use post-intervention.
• Identified improvements include refining content, addressing rebound insomnia, adding leaflets, and enhancing patient support.

Conclusions:

• The brief intervention (BI) is feasible and acceptable for older adults misusing z-hypnotics.
• The study identified key areas for intervention refinement before a larger RCT.
• The findings support the integration of BI into future trials for managing z-hypnotic dependence in the elderly.