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One-time counselling decreases the use of benzodiazepines and related drugs among community-dwelling older persons

Publisher: 
Oxford University Press on behalf of the British Geriatrics Society.
Author: 
Maritta Salonoja1, Marika Salminen2, Pertti Aarnio3, Tero Vahlberg4 and Sirkka-Liisa Kivelä2,5,6
Date published: 
20 January, 2010
Region: 
International

Publication type: 
research

1 Department of Geriatrics, Satakunta Hospital District, Pori, Sairaalantie 3, FI-28500, Finland
2 Institute of Clinical Medicine, Department of Family Medicine, University of Turku, Turku, Lemminkäisenkatu 1, FI-20014, Finland
3 Department of Surgery, Satakunta Hospital District, Pori, Sairaalantie 3, FI-28500, Finland
4 Institute of Clinical Medicine, Department of Biostatistics, University of Turku, Turku, Lemminkäisenkatu 1, FI-20014, Finland
5 Satakunta Hospital District, Pori, Sairaalantie 3, FI-28500, Finland
6 Unit of Family Medicine, Turku University Hospital, Turku, Kiinamyllynkatu 4-8, FI-20520, Finland

Address correspondence to: M. Salonoja. Tel: (+358) 2 627 6705; Fax: (+358) 2 627 6709. Email: maritta.salonoja@satshp.fi

Background: evidence about possibilities to help older persons to withdraw the long-term use of benzodiazepines (BZD) is scarce. Effective and practicable methods are needed.

Objective: the study aimed to assess the persistence of one-time counselling by a geriatrician to reduce psychotropic drugs, especially BZD and related drugs (RD).

Design: a prospective randomised controlled trial with a 12-month follow-up was conducted.

Subjects: five hundred ninety-one community-dwelling people aged 65 or older participated in the study.

Methods: instructions to withdraw, reduce or change psychotropic drugs were given to the intervention group. A 1-h lecture about these drugs and their adverse effects was given later on. No changes in the drug therapy were suggested for the controls.

Results: the number of regular users of BZD and RD decreased by 35% (12/34) (odds ratios (OR) = 0.61, 95% confidence interval (95% CI) 0.44–0.86) in the intervention group while it increased by 4% (2/46) (OR = 1.05, 95% CI 0.81–1.36) in the controls (P = 0.012). No significant changes in the users of other types of psychotropics were found.

Conclusion: one-time counselling of psychotropics and other fall-risk-increasing drugs by a geriatrician followed with a 1-h lecture about adverse effects of these drugs had positive effects in decreasing the number of regular users of BZD and RD, and these effects persisted for the total 12-month intervention period.

 

Keywords: older people, home-dwellers, reduction of benzodiazepines, randomised controlled trial, elderly

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