Trial reportThe Permanente journal2019
Patient Education and Pharmacist Consultation Influence on Nonbenzodiazepine Sedative Medication Deprescribing Success for Older Adults.
Trial report in The Permanente journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Z-drug abuse and dependence: clinical guideline of the Brazilian Academy of Neurology for diagnosis and management.Arquivos de neuro-psiquiatria · 2025Guideline
- Deprescribing Benzodiazepine Receptor Agonists in Older Adults and People With Cognitive Impairment: A Systematic Review.Journal of the American Geriatrics Society · 2025Pooled it
- Comparative effectiveness of interventions to facilitate deprescription of benzodiazepines and other sedative hypnotics: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2025Pooled it
- Deprescribing in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Outcomes in deprescribing implementation trials and compliance with expert recommendations: a systematic review.BMC geriatrics · 2023Pooled it
- Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis.Addiction (Abingdon, England) · 2020Pooled it
- Reducing Central Nervous System-Active Medications to Prevent Falls and Injuries Among Older Adults: A Cluster Randomized Clinical Trial.JAMA network open · 2024Trial
- Deprescribing Anticholinergic and Sedative Drugs to Reduce Polypharmacy in Frail Older Adults Living in the Community: A Randomized Controlled Trial.The journals of gerontology. Series A, Biological sciences and medical sciences · 2023Trial
- Recommendations on Switching or Deprescribing Hypnotic Medications for Insomnia.Deutsches Arzteblatt international · 2026Review
- Substitution Patterns After Discontinuation of CNS-Active Medications in Older Adults in Primary Care.Journal of the American Geriatrics Society · 2026Article
- Sleep should not be this difficult: An interpretive descriptive study of older adults' perspectives on behaviour change elements in Sleepwell and experiences with benzodiazepine discontinuation.Journal of sleep research · 2025Article
- Influence of Potentially Inappropriate Medication Use on Older Australians' Admission to Emergency Department Short Stay.Geriatrics (Basel, Switzerland) · 2024Article
- [Safe discontinuation of psychotropic drugs in older people? : New evidence and practical approach].Der Nervenarzt · 2024Review
- Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2024Review
- Alliance for Sleep Clinical Practice Guideline on Switching or Deprescribing Hypnotic Medications for Insomnia.Journal of clinical medicine · 2023Review
- [Safe discontinuation of psychotropic drugs in older people? : New evidence and practical approach].Zeitschrift fur Gerontologie und Geriatrie · 2023Review
- Co-design to increase implementation of insomnia guidelines in primary care.Patient education and counseling · 2022Article
- Applying the intervention Complexity Assessment Tool to brief interventions targeting long-term benzodiazepine receptor agonist use in primary care: Lessons learned.BMC primary care · 2022Article
- Sleep Medication in Older Adults: Identifying the Need for Support by a Community Pharmacist.Healthcare (Basel, Switzerland) · 2022Article
- Patient and Physician Perspectives of Deprescribing Potentially Inappropriate Medications in Older Adults with a History of Falls: a Qualitative Study.Journal of general internal medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionUse of nonbenzodiazepine sedative hypnotics or "Z-drugs"-including eszopiclone, zolpidem, or zaleplon-is discouraged for older adults; however, these medications commonly are prescribed to treat insomnia in this population. We evaluated the impact of direct-to-patient education, with or without a pharmacist consultation, on Z-drug discontinuation among Kaiser Permanente Northwest members age 64 years and older.
methodsWe randomized 150 patients to usual care (UC), educational information only, or educational information and pharmacist consultation. Patients age 64 years and older who received 2 to 3 Z-drug fills in 2016 were included. Logistic regression was used to calculate odds of discontinuation at 6 months among patients who received either intervention, compared with those who received UC.
resultsPatients who received education only and education plus pharmacist consultation were significantly more likely to discontinue Z-drug use than those who received UC (28/50 of those who received education only and 27/49 of those who received education plus consultation vs 13/50 patients who received UC). After controlling for patient demographics, comorbidity, and antianxiety and antidepressant medication use, patients who received education only had greater odds of Z-drug discontinuation than those in the UC group (adjusted odds ratio = 4.02, 95% confidence interval = 1.66-9.77). Patients who received education and a pharmacist call also had greater odds of discontinuing use of these drugs than those in the UC group (adjusted odds ratio = 4.10, 95% confidence interval = 1.65-10.19).
conclusionPatients who received direct-to-patient education with or without a pharmacist consultation were significantly more likely to discontinue Z-drug use than patients receiving UC. Providing evidence-based information about Z-drug use is an effective and low-resource method to encourage drug discontinuation.
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