97 Prescribing of Hypnosedatives in Seniors in Ambulatory Care in the Czech Republic: Inomed and Euroageism Project Findings

Introduction Among psychotropic drugs, particularly hypnotics are often used by ambulatory seniors due to high prevalence of insomnia in higher age. This study focused on describing the prevalence of insomnia, prevalence of hypnosedative drug use and inappropriate patterns of their prescribing (nongeriatric doses, nongeriatric lenght of therapy) in ambulatory seniors in the Czech Republic. Methods There were 563 ambulatory geriatric patients (≥65 years) included in the study, from 4 geriatric ambulances (regionally different sites) in the Czech Republic. All patients have been assessed using comprehensive geriatric assessment (CGA) using the EUROAGEISM H2020 study protocols. Prevalences of insomnia, hypnosedative drug use and use of drugs that may exacerbate insomnias were documented by descriptive statistics, as well as the prevalence of potentially inappropriate medications in older patients (PIMs, selectively for hypnosedatives, defined by 2019 Beers criteria and 2015 EU(7)-PIM list). Results 30.6% (N = 172) of ambulatory seniors suffered from insomnias and the majority of patients were treated pharmacologically (24.0%), nonpharmacologic procedures were used rarely (0.5%). Hypnosedatives in the evening or at night (e/n) were mostly prescribed in the age group of patients 84–94 years (42.8%) and most often these were Z-drugs (8.2%), benzodiazepines (BZDs, 7.6%) and from „off-label “hypnotics antipsychotics (17.8%,!17% of users 6 months) and sedative antidepressants (9.2%). In nongeriatric doses and nongeriatric duration of therapy (>4 weeks) there were most often prescribed Z-drugs (6.0% and 2,7%, respectively) and BZDs (2,7% and 11%). Conclusion In ambulatory Czech seniors we documented that one third suffered from insomnias and minimally were applied nonpharmacological treatment strategies. From nongeriatric procedures in hypnosetive drug use were most often described long-term use of antipsychotics e/n, non-geriatric dosing of Z-drugs and long-term use of BZDs e/n. Supported by: InoMed project (reg. No: CZ.02.1.01/0.0/0.0/18_069/0010046, 2019–2022), EUROAGEISM H2020-MCSF-ITN-764632 project, PROGRESS Q42 Faculty of Pharmacy, Charles University, SVV 260417.