A package of Docrium sleeping medication. LEHTIKUVA
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A recent study has highlighted a concerning trend among physicians prescribing sleep medications to elderly patients with insufficient dosage instructions. The research, conducted by Kela (The Social Insurance Institution of Finland) and the University of Helsinki, found that a significant portion of sleep medication prescriptions for seniors lack comprehensive details, such as the duration of use and instructions for discontinuation. Additionally, issues were identified in the selection and distribution of these medications.
Nearly all sleep medications prescribed to the elderly are classified as high-risk, meaning they carry a substantial risk of serious side effects. Proper dosage instructions are crucial, especially for medications affecting the central nervous system, which can have adverse effects particularly in older adults.
The study revealed that doctors often issue dosage instructions missing one or several essential pieces of information. Analysis of pharmacy-dispensed sleep medication instructions showed that 98% specified the amount of medication to be taken, 83% indicated the time of day for intake, and 57% mentioned the duration of the treatment. Only 5% included discontinuation instructions, and a mere 3% contained warnings related to use.
“The deficiencies in dosage instructions for the elderly’s sleep medication prescriptions are alarming. We hope our research reminds doctors of the importance of providing comprehensive information in the dosage instructions to support the success of the patient’s treatment,” says Terhi Kurko, a special researcher at Kela.
The study specifically looked at the three most commonly dispensed medications for insomnia among the elderly: zopiclone, mirtazapine, and zolpidem, which together accounted for 87% of all medication deliveries in this group. These medications should be prescribed cautiously or only for short-term use in elderly patients’ care.
Surprisingly, nearly half of all medication deliveries examined in the study utilized automated dose dispensing, intended for patients on multiple regular medications over a long term. Yet, a significant number of medications intended primarily for short-term and temporary use were dispensed this way.
“The high prevalence of automated dose dispensing in all medication deliveries was an unpleasant surprise. It included many medications that should be prescribed to the elderly only with great caution,” says Tomi Rantamäki, the study’s lead researcher and a professor of pharmacology at the University of Helsinki.
The researchers extracted data from over a million medication deliveries compensated through Kela’s health insurance for the elderly in 2022. They focused on deliveries where individuals aged at least 75 had purchased medication classified as a sleep aid according to the “Current Care Guidelines” for insomnia. Out of these, nearly 330,000 deliveries were associated with the treatment of insomnia. This study underscores the need for improved prescribing practices and awareness among healthcare providers when treating insomnia in the elderly population.
HT
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Source: www.helsinkitimes.fi
