Half of elderly patients become chronic sleeping pill users

Half of elderly patients prescribed a type of sleeping pill upon release from hospital are chronic users of the drug six months later, finds a study released Monday.

The study by the Institute for Clinical Evaluative Sciences (ICES) found that half of elderly patients who were prescribed benzodiazepines for the first time in hospital were still using the drug six months later.

Benzodiazepines are a commonly prescribed drug in Canada, with millions of prescriptions each year. The drug is commonly prescribed in hospital tohelp patientscope with anxiety and insomnia.

The drug's side-effects include lingering daytime sedation and cognition problems, whichare intensified in older patients. Benzodiazepines have been linked to motor vehicle collisions and to falls and related injuries, andcan be addictive.

From April 1992 to March 2005, the study trackedseniors 66 and older who had not been prescribed benzodiazepine drugs in the year before hospitalization.

Of almost 12,500 patients prescribed the sleeping pills during the study, more than 6,100 were still taking the drug during the next six months.

The study also identified patients who were at high-risk of becoming chronic users. People at riskincluded patients who were:

• Women.
• Admitted to the intensive care unit of non-surgical wards.
• Hospitalized longer.
• Diagnosed with additional illnesses.
• Previously diagnosed with alcoholism.
• Prescribed more medications.

Older individuals had a lower risk of becoming chronic users.

Study highlights health-care weakness

Dr. Chaim Bell, the lead author of the study and an ICES adjunct scientist, says thestudyrevealed an area of health care that could be improved.Patients who were not taking benzodiazepine before their hospitalization continued to receive and take the drug after discharge, risking a chronic addiction.

"The issue that I really want to highlight is the transition, the continuity of care from hospital to community," he told CBC.ca. "We need medication reconciliation, looking at what medications people are on before hospitalization, what they're prescribed during hospitalization, and reconciling things when they're discharged."

Bell says there needs to be better co-ordination between the hospital and personal doctors tohelp patients transition from treatment in hospitalto home, and tohelp reduce the risk of new chronic users.

As well, initiatives such as the development of electronic medical records and formal medication lists may help to further reduce the risk.