Advertisement

Pharmacy World & Science

, Volume 29, Issue 6, pp 611–618 | Cite as

Does hospitalisation affect hypnotic and anxiolytic drug prescribing?

  • Philippe Fagnoni
  • Samuel Limat
  • Emmanuel Haffen
  • Thierry Henon
  • Micheline Jacquet
  • Daniel Sechter
  • Marie Christine Woronoff-LemsiEmail author
Original Paper

Abstract

Objective

The aim of this study was to measure the impact of hospitalisation on hypnotic and anxiolytic (HA) drug prescription, during and after hospitalisation.

Method

A descriptive study was carried out over three periods: before, during and after hospitalisation (three-month follow-up), examining the presence or absence of HA treatment at each stage. The HA drug list studied was selected using the World Health Organisation (WHO) Anatomical Therapeutic and Chemical (ATC) classification system. Trained final-year pharmacy students asked a series of structured questions during hospitalisation and postal questionnaires were sent to included patients one and three months after discharge. All the in-patient departments in the University Hospital of Besançon—France—were included, except units with pre-, peri-, and post-operative HA treatments. All in-patients present in the selected units on February 12, 2003, aged over 18, who gave their consent and were considered able to answer by the nursing team, were finally included.

Main outcome measure

An eight-branch descriptive model, including the three study periods with two states (presence or absence of HA treatment) at each stage.

Results

A total of 260 in-patients were included, and a further 112 (43%) completed the whole study (alive, non re-hospitalised, one- and three- months post discharge response). 48% (n = 260), 64% (n = 260) and 58% (n = 112) of the included patients had sleep disorder complaints respectively before, during and after hospitalisation. HA usage increased when comparing pre- and during hospitalisation (33% vs. 51%; n = 112; p < 0.0001) and decreased when comparing during hospitalisation and post-discharge (51% vs. 43%; n = 112; p < 0.0001). The descriptive model showed an overall persistence of treatment induced by hospital stay in 5.35% of the patients.

Conclusion

Hospital appeared to have a significant impact on delayed HA use in the French general population. Our results should incite hospital prescribers to transversally reconsider the whole sleep disorder treatment strategy in hospital settings, from improving patient’s accommodation conditions, to working out a consensus on the justification of prescription of HA and precising the exact place of nursing team in sleep disorders management.

Keywords

Anxiolytics France Hospital Hypnotics Insomnia Medicine use Outpatient Sedatives Prescribing 

Notes

Acknowledgments and public financial support

Conflicts of Interest This study has been carried out in the regional framework of «Projet Hospitalier de Recherche Clinique 2001». There is no potential conflict of interest that might be relevant to the content of this manuscript.

References

  1. 1.
    Zarifian E. Rapport: mission générale concernant la prescription et l’utilisation des médicaments psychotropes en France. Paris: La documentation Française; 1996.Google Scholar
  2. 2.
    Pelissolo A, Boyer P, Lepine JP, Bisserbe JC. Epidémiologie du recours aux médicaments anxiolytiques et hypnotiques en France et dans le monde [Epidemiology of the use of anxiolytic and hypnotic drugs in France and in the world]. Encéphale 1996;22(3):187–96.PubMedGoogle Scholar
  3. 3.
    Lecomte T, Paris V. Consommation pharmaceutique en 1988 [Pharmaceutical consumption in 1988]. Bul CREDES 1991;881:116–7.Google Scholar
  4. 4.
    Caisse Nationale d’Assurance Maladie des Travailleurs Salariés MEDIC’Assurance Maladie. Les médicaments remboursés par le régime Général d’Assurance Maladie au cours des années 2000 et 2001. Paris: CNAMTS; 2002.Google Scholar
  5. 5.
    France. Ministère de la Santé et de l’action humanitaire. Arrêté du 7 Octobre 1991 fixant la liste des substances vénéneuses à propriété hypnotique et/ou anxiolytique dont la durée de prescription est réduite (modifié par les arrêtés du 28/01/1992, 18/08/1992, 03/09/1992, 01/02/2001, 21/12/01). J Off Repub. Arrêtés 2001; (n°01-24440):321.Google Scholar
  6. 6.
    Ohayon M, Caulet M, Lemoine P. Patients âgés, habitudes de sommeil et utilisation de psychotropes dans la population française [The elderly, sleep habits and use of psychotropic drugs by the French population]. Encéphale 1996;22(5):337–50.PubMedGoogle Scholar
  7. 7.
    Zarifian E. Le prix du bien-être—psychotropes et société [The price of the wellbeing—psychotropic and society]. Paris: Editions Odile Jacob; 1996, ISBN 27-381-0405-3.Google Scholar
  8. 8.
    Edwards C, Bushnell JL, Ashton CH, Rawlins MD. Hospital prescribing and usage of hypnotics and anxiolytics. Br J Clin Pharmacol 1991;31(2):190–2.PubMedGoogle Scholar
  9. 9.
    Picone DA, D’Mello DA, Foote ML, Msibi B. A review of the utilisation of sedative-hypnotic drugs in a general hospital. Gen Hosp Psychiatry 1993;15(1):51–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Feely J, Chan R, McManus J, O’Shea B. The influence of hospital based prescribers on prescribing in general practice. Pharmacoeconomics 1999;16(2):175–81.PubMedCrossRefGoogle Scholar
  11. 11.
    Riviere F, Bonnin M, Saux MC, Hazane C. L’hôpital est-il inducteur de la consommation d’hypnotiques? [Does hospitalisation induce hypnotic drug prescription?] Rev ADPHSO 1987;12(3):51–7.Google Scholar
  12. 12.
    Savoy J, Fauchere PA, Ferrero F. La prescription des psychotropes dans un hôpital général [Prescription of psychotropic drugs in a general hospital]. Med Hyg 1997;55:1704–5.Google Scholar
  13. 13.
    Ancoli-Israel S. Sleep problems in older adults: putting myths to bed. Geriatrics 1997;52(1):20–10.PubMedGoogle Scholar
  14. 14.
    Epstein DR, Bootzin RR. Insomnia. Nurs Clin North Am 2002;37(4):611–31.PubMedCrossRefGoogle Scholar
  15. 15.
    Shaver JL. Women and sleep. Nurs Clin North Am 2002;37(4):707–1.PubMedCrossRefGoogle Scholar
  16. 16.
    Maling TJ, Moon PA. Hypnotic drug prescribing and consumption in a New Zeland teaching hospital. N Z Med J 1983;96(740):730–3.PubMedGoogle Scholar
  17. 17.
    Villani P, Morciano C, Ambrosi P, Brondino-Riquier R, Bertault-Peres P, Penot-Ragon C, Bouvenot G. Prescriptions et consommations de médicaments hypnotiques et anxiolytiques au CHU-Sud de Marseille [Prescriptions and consumption of hypnotic and anxiolytic drugs in the South University Hospital of Marseille]. Thérapie 2001;56(1):11–4.PubMedGoogle Scholar
  18. 18.
    Empereur F, Baumann M, Alla F, Briancon S. Factors associated with the consumption of psychotropic drugs in a cohort of men and women aged 50 and over. J Clin Pharm Ther 2003;28(1):61–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Ohayon M, Lemoine P. Relations entre l’insomnie et les autres pathologies psychiatriques dans la population française [A connection between insomnia and psychiatric disorders in the French general population]. Encephale 2002;28(5pt1):420–8.PubMedGoogle Scholar
  20. 20.
    Leger D, Allaert FA, Massuel MA. La perception de l’insomnie en médecine générale. Enquête auprès de 6 043 médecins généralistes. [Attitudes about insomnia and its effect on daytime functioning. Survey of 6043 French general practitioners]. Presse Med 2005;34(19 Pt 1):1358–62.PubMedGoogle Scholar
  21. 21.
    Ohayon MM, Lemoine P. Répercussions diurnes de l’insomnie dans la population générale française [Daytime consequences of insomnia complaints in the French general population. Encéphale 2004;30(3):222–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Neubauer D. Pharmacologic approaches for the treatment of chronic insomnia. Clin Cornerstone 2003;5(3):16–27.PubMedCrossRefGoogle Scholar
  23. 23.
    Dement WC, Pelayo R. Public health impact and treatment of insomnia. Eur Psychiatry 1997;12(suppl1):31s–38s.CrossRefGoogle Scholar
  24. 24.
    Carey DL, Day RO, Cairns DR, Pearce GA, Wodak AD, Lauchlan RL. An attempt to influence hypnotic and sedative drug use. Med J Aust 1992;156(6):389–4.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Philippe Fagnoni
    • 1
    • 2
  • Samuel Limat
    • 1
    • 3
    • 4
  • Emmanuel Haffen
    • 5
    • 6
  • Thierry Henon
    • 1
  • Micheline Jacquet
    • 1
  • Daniel Sechter
    • 5
    • 6
  • Marie Christine Woronoff-Lemsi
    • 1
    • 2
    Email author
  1. 1.Department of PharmacyUniversity Hospital of BesançonBesanconFrance
  2. 2.INSERM, U 645 EA-2284 IFR-133University of Franche-ComteBesanconFrance
  3. 3.School of PharmacyUniversity of BourgogneDijonFrance
  4. 4.INSERM, EPI 106University of BourgogneDijonFrance
  5. 5.Department of Clinical PsychiatryUniversity Hospital of BesançonBesanconFrance
  6. 6.School of Medicine and PharmacyUniversity of Franche-ComteBesanconFrance

Personalised recommendations