2024 年 50 巻 7 号 p. 351-365
We investigated the influence of pharmacists’ efforts to taper and discontinue treatment with benzodiazepine receptor agonists (BZs) in hospitalized patients who could communicate and expected ≥14 days of hospitalization at a nonpsychiatric hospital (February 25, 2021 – February 24, 2022). Patients on psychiatrically prescribed BZs were excluded. A predesigned physician consent protocol for tapering or discontinuing the BZ treatment was established. After obtaining patient consent, we proposed a prescription according to this protocol to the patients’ attending physicians while repeatedly monitoring the patients’ sleep status. The outcome measures were the percentage of patients achieving BZ tapering or withdrawal, the diazepam-equivalent dose, the patients’ sleep quality per the Athens Insomnia Scale (AIS), and adverse effects (AEs). A total of 14 patients were enrolled (5 males, 9 females; median age 80.5 years), 13 of whom were followed up. Ten patients (77％) reduced or discontinued BZ intake. The median diazepam-equivalent significantly decreased from 3.75 mg/day to 2 mg/day (P < 0.05). The mean AIS score improved from 6.7 (suspected insomnia) to 4.6 (suspected mild insomnia) (P = 0.08). The percentage of patients experiencing anxiety and transient forgetfulness decreased from 90％ to 50％ (P = 0.14) and 40％ to 0％ (P = 0.09), respectively. The change in sleep quality and the incidence of AEs were not significant, but the clinical significance of these parameters is important. Our results suggest that pharmacist support in the inpatient setting can lead to a reduction or discontinuation of BZ medications, which may improve patients’ sleep quality and reduce AEs.
