A systematic review of regulatory and educational interventions to reduce the burden associated with the prescriptions of sedative-hypnotics in adults treated for sleep disorders

نویسندگان

  • Elsa Bourcier
  • Virginie Korb-Savoldelli
  • Gilles Hejblum
  • Christine Fernandez
  • Patrick Hindlet
چکیده

BACKGROUND The burden of Sedative-Hypnotics (SHs) has been known since the 1980s. Yet, their consumption remains high. A systematic review of the literature should help to assess efficient interventions to improve the appropriate use of SHs in sleep disorders. OBJECTIVES To identify and assess regulatory and educational interventions designed to improve the appropriate use of SHs for insomnia treatment. METHODS We conducted a systematic review of the literature according to PRISMA guidelines. A systematic search covering the period 1980-2015 was carried out in Medline, Web of Science, Embase and PsycInfo. We included studies reporting the implementation of regulatory or educational strategies directed towards patients and/or healthcare professionals to improve the appropriate use of SHs to treat insomnia in the community, hospitals and nursing homes. RESULTS Thirty-one studies were included: 23 assessed educational interventions (recommendations by mail/email, computer alerts, meetings, mass media campaigns, prescription profile), 8 assessed regulatory interventions (prescription rule restriction, end of reimbursement). The most recent was implemented in 2009. Restrictive prescription rules were effective to reduce the consumption of targeted SHs but led to a switch to other non-recommended SHs. Among educational interventions, only 3 studies out of 7 reported positive results of mono-faceted interventions; whereas, 13 out of the 16 multi-faceted interventions were reported as efficient: particularly, the active involvement of healthcare professionals and patients and the spread of information through mass media were successful. The risk of bias was high for 24 studies (mainly due to the design), moderate for 3 studies and weak for 4 studies. CONCLUSION Educational multifaceted studies are presented as the most efficient. But further better designed studies are needed to make evidence-based results more generalizable.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

High Prevalence of Inappropriate Benzodiazepine and Sedative Hypnotic Prescriptions among Hospitalized Older Adults.

BACKGROUND Benzodiazepines and sedative hypnotics are commonly used to treat insomnia and agitation in older adults despite significant risk. A clear understanding of the extent of the problem and its contributors is required to implement effective interventions. OBJECTIVE To determine the proportion of hospitalized older adults who are inappropriately prescribed benzodiazepines or sedative h...

متن کامل

P41: Health-Related Quality of Life in Adults with Epilepsy: A Systematic Review

Considering the burden of epilepsy on society, investigation of the health-related quality of life (HRQoL) is essential for the better future targeting, optimization of current interventions and managing strategies for epilepsy. Nineteen HRQoL were investigated in this review. Increases in seizure incidence, level of depression and seizure severity were significantly related to reduced HRQoL. T...

متن کامل

The effect of exercise and physical activity on sleep quality and quality of life in Iranian Older Adults: A systematic review

Introduction: Quality of sleep and quality of life are two very important factors that improving them can help improve the quality of life of the elderly, in which exercise and physical activity play an important role. Therefore, the purpose of this study was to systematically review studies on the effect of exercise and physical activity on sleep quality and quality of life in the elderly in I...

متن کامل

Psychological interventions and characteristics affecting COVID-19 and its resulting Psychopathology: A systematic review study

Coronavirus disease   (COVID-19), which is a threat to global health, in addition to endangering physical health, will exert irrecoverable psychological effects. Due to this, it is necessary to know the positive psychological factors and effective psychological therapies to deal with this disease. the purpose of this study was to investigate interventions and psychological characteristics affec...

متن کامل

Psychological Distress in Patients With Multiple Sclerosis and Epilepsy in the COVID-19 Pandemic: A Systematic Review

Background: The COVID-19 pandemic can cause various anxiety, fear, and tension in society. The negative impact of the pandemic is not limited to physical health problems. It can generate serious consequences, such as anxiety, depression, and stress, especially neurological diseases.  Objectives: The present study investigated depression, anxiety, and stress in patients with MS and epilepsy dur...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 13  شماره 

صفحات  -

تاریخ انتشار 2018