Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 15, 2023
Date Accepted: Jan 18, 2024
Brief intervention as a method for reducing use of z-hypnotics in the older adult: a feasibility case series
ABSTRACT
Background:
Z-hypnotics or z-drugs are commonly prescribed for insomnia and sleep difficulties in older adults. These drugs are associated with adverse events and dependence and are not recommended for long-term use. Despite clinical guidelines, inappropriate use is still prevalent. Brief intervention (BI) is a method used to treat patients at risk of substance overuse.
Objective:
In this study we assessed the feasibility of adapting BI for reducing use of z-hypnotics in older adults.
Methods:
This feasibility case series was conducted at Akershus University Hospital, Norway autumn 2021. Five adults aged ≥65 with long-term use of z-hypnotics (≥4weeks) and two intervening physicians were included. The BI consisted of information on risk of inappropriate use and individualised advice on how to reduce use. Quantitative and qualitative data were collected at baseline and six weeks follow-up. The aim was to achieve feedback on the logistics, feasibility and acceptability of the intervention.
Results:
Five participants (four female) with median age of 84 were included. Average time spent on the BI consultation was 15 minutes. Participants and the two intervening physicians reported the intervention as acceptable. Two participants stopped their use of z-hypnotics completely and participated in the follow-up interview. Aspects that may improve the intervention and reduce drop-outs were identified as revising the intervention content, adding an information leaflet, and supporting the patient after the intervention.
Conclusions:
We identified important aspects for improving the designed intervention in preparation for larger randomised trial investigating treatment effect of a BI for reducing use of z-hypnotics in older adults. Clinical Trial: NCT03162081, 22 May 2017
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