Intervention minimale pour réduire l’usage chronique des benzodiazépines : étude auprès de patients chuteurs de plus de 65 ans, traités par benzodiazépines et admis aux Urgences du CHU Gabriel-Montpied de Clermont-Ferrand

Abstract : Objective :The main objective of this study was to prove that sending a letter about the side effects of benzodiazepines (BZD) and of related drugs to patients admitted after a fall in an emergency service would make a reduction of these molecules easier. Secondary objectives were to evaluate over a three month elapsed time, repeated falling cases, anxiety and insomnia occurrences as well as initiating a discussion with the general practitioner. Method : A single-center comparative study « Before / After » on a sample of 65 year old patients and over, BZD consumer for more than 30 days, in emergency care after a fall. Study exclusion criteria were missing information in computer records, anti-epileptic BZD therapy, chronic psychosis, severe dementia, Parkinson's disease, chronic alcoholism and patients at end-of-life. The BZD side effects letter was sent to the patient within one month of the fall. To collect the evaluation criteria, a phone call was made to the patient 3 months later. The main evaluation criterion was the rate of patient who had decreased their BZD intake after 3 months and the study aimed at carrying out a medical treatment. Results : 139 patients were included in the “Before Group” (14/09/2016 to 24/12/2016) and 153 patients in the “After Group” (25/12/2016 to 27/04/2017). Both groups were similar as far as age, gender, residency, multiple medication, falls history log, underlying dementia are concerned as well as in cases of admission in hospital subsequently to emergency care. Tracks of 12 patients were lost and 21 patients died. 23 patients did not receive the letter. The study showed a significantly greater decrease in BZD consumption in the recipient group (47% versus 25%, p <0.001), not a significant decrease in reoccurrences of falls in the recipient group (22% versus 30%, p = 0.131). There was neither an increase in anxiety (32% versus 48% control group, p=0.01) nor of insomnia (17% versus 35% control group, p<0.001). A discussion with the general practitioner took place for 46% of the patients having received the letter. Conclusion : These results call for the systematic sending of an information letter to patients older than 65, treated with BZD and admitted after a fall in an emergency service, in order to discontinue long-term BZD and related hypnotics.
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Cécile Condy. Intervention minimale pour réduire l’usage chronique des benzodiazépines : étude auprès de patients chuteurs de plus de 65 ans, traités par benzodiazépines et admis aux Urgences du CHU Gabriel-Montpied de Clermont-Ferrand. Sciences du Vivant [q-bio]. 2017. ⟨dumas-02056565⟩

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