Concurrent Sessions

B1 – When Things Aren’t Adding Up, Start Subtracting! De-Prescribing Sedative-Hypnotics

Theme 1. Mental health and addictions

Presentation Details

  • Date: Wednesday, October 24, 2018
  • Concurrent Session B
  • Time: 3:30-4:15pm
  • Room: Harbour A
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives

  • Review updated evidence on the risk and safety concerns associated with the use of benzodiazepines/Z-drugs in older adults
  • De-prescribing in primary care
  • Setting goals, creating a workplan, and tracking outcomes
  • How to implement a benzodiazepine/Z-drug de-prescribing initiative in your clinical practice

Summary/Abstract

TC FHT’s Quality Improvement Committee (QIC) and St. Michael’s Hospital’s Mental Health & Addiction Service Research Team, collaborated to develop the De-prescribing (tapering & stopping) of benzodiazepines & Z-Drugs QI initiative.  The purpose of the initiative is to reduce the unnecessary use of benzodiazepines and/or Z-drugs among older adults (age 65 and above).  Studies have shown increased risk of adverse effects (i.e. falls, pneumonia, interference with cognition) when taking these medications.  This QI and medication safety initiative is about informing patients of the risks and offering support if they wish to taper or stop taking these drugs, and informing providers of these risks and how to support patients. An interprofessional team comprised of MDs, NPs, Pharmacists, Social Workers and Nurses was created to implement this QI initiative. A detailed workplan outlining the step-by-step process was developed by an appointed QIC working group. This workplan emphasized optimization of existing clinical programs and resources, including CBT-insomnia workshops, drop-in sessions with the Social Work team, and medication tapering support with MDs and/or Pharmacists. Some of the highlights that made this initiative successful included educating clinicians about the latest evidence on the safety concerns associated with these medications and informing patients about the potential risks of taking these medications. Patient empowerment and self-advocacy for medication tapering was also emphasized by utilizing an evidence-based patient-directed tapering tool.

Presenters

  • Jessica Lam, Registered Pharmacist, Taddle Creek Family Health Team
  • Ranjana Shardha, Director of QI, Taddle Creek Family Health Team

Authors & Contributors

  • Sherry Kennedy, Executive Director Taddle Creek FHT