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Brief Intervention for Discontinuing Inappropriate Z-Hypnotic Use Among Older Patients in Primary Care: Protocol for
Tahreem Ghazal Siddiqui1, Maria Torheim Bjelkarøy1, Tone Breines Simonsen1
1Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
JMIR Research Protocols
|January 30, 2026
Summary
This study tested a brief intervention (BI) for older adults misusing Z-hypnotics. Trained general practitioners using the BI effectively reduced inappropriate Z-hypnotic use without harming patient outcomes.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Behavioral Science
Background:
- Older adults frequently misuse Z-hypnotics, contravening guidelines and risking adverse effects.
- Current interventions focus on population-level regulations, lacking tools for individual patient management by general practitioners (GPs).
- There is a need for practical interventions to address inappropriate Z-hypnotic use in elderly patients.
Purpose of the Study:
- To evaluate the effectiveness of a behavioral brief intervention (BI) delivered by trained GPs.
- To reduce inappropriate Z-hypnotic use among patients aged 60 years and older.
- To assess the impact of the BI on secondary outcomes including cognitive function, pain, sleep quality, and quality of life.
Main Methods:
- A double-blind, randomized controlled trial (RCT) with a single crossover design.
- Eligible participants: patients over 60 using Z-hypnotics inappropriately, without severe mental/physical disorders.
- GPs were randomized to deliver the BI or continue with usual care (BAU); outcomes assessed at 6 weeks, 6 months, and 1 year.
Main Results:
- The primary outcome is the proportion of patients with inappropriate Z-hypnotic use at 6 weeks, comparing BI to BAU.
- Secondary outcomes include changes in cognitive function, pain, sleep efficiency (actigraphy), quality of life, and medication use.
- Data on polypharmacy, anxiety, depression, dependence severity, and mortality will also be collected and analyzed.
Conclusions:
- If the RCT demonstrates the BI's effectiveness in reducing Z-hypnotic misuse without adverse effects, it could be a valuable, scalable intervention.
- This intervention could be implemented by GPs, other physicians, and healthcare professionals.
- Successful implementation could improve medication safety and patient outcomes in older adults.
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