New evidence-based deprescribing guideline released to help reduce the use of potentially addictive sleeping pills
05/30/2018
A group of Canadian health care professionals has developed the first evidence-based Deprescribing Guideline to reduce or stop the use of Benzodiazepines (BZRAs), a class of medications commonly prescribed for anxiety, insomnia and stress. Long-term prescription of this class of drugs can lead to harm and abuse. The goal of this guideline is to reduce or remove the drug from a patient’s regimen without harming the patient.
This Deprescribing Guideline is a practical tool designed to facilitate better collaboration between patients and physicians during the deprescribing process. This tool can help remove a drug that does more harm than good to patients.
Jocelyne Drouin-Delowsky was prescribed Clonazepam, a drug classified under the BZRA banner. What followed was a long battle to remove the drug from her life. “I was on Clonazepam for 32 years,” she explains. “It was a security blanket for me. After being introduced to the drug, I just couldn’t stop. It messes with your head.”
Thanks to this collaborative deprescribing method between Jocelyne and her physician, she was able to gradually stop using the drug.
Researchers have associated BZRAs with motor vehicle accidents, memory problems and daytime sleepiness. Older adults are particularly susceptible to the associated harms of long-term BZRA use.
Despite these risks, BZRAs are one of the most overly prescribed classes of drugs. In 2012, over 15 per cent of Canadians used BZRAs, with up to 30 per cent of them being seniors. In addition, up to 30 per cent of opioid deaths involve the use of BZRAs.
"Doctors learn how to prescribe drugs, but not always when or how to stop them,” explains Dr. Kevin Pottie, investigator at the Bruyère Research Institute and lead author of the guideline. “This evidence-based guideline is the first of its kind to help us deprescribe BZRAs.”
The guideline has been published in Canadian Family Physician, the official journal of the College of Family Physicians of Canada. It has also been endorsed by the Canadian Pharmacists Association. This guideline is focused on giving prescribers the tools they need to make informed decisions on how to reduce and remove these drugs from their patients’ regimens.
The guideline informed the development of the BZRA Deprescribing Algorithm. This is a decision-making flowchart designed to help clinicians make appropriate decisions on when to deprescribe BZRAs with their patients. This, as well as other deprescribing tools, can be found on the deprescribing.org website.
About the Bruyère Deprescribing Guidelines Research Team
The Bruyère Deprescribing Guidelines Research Team, led by Barbara Farrell, PharmD, is made up of scientists, pharmacists and physicians who began their work in 2013 with the support of a Health System Research Fund (HSRF) program grant from the Government of Ontario.
About the Bruyère Research Institute
The Bruyère Research Institute supports investigators who contribute to a better, more responsive health care system that delivers the best care to patients, residents and families. The Institute is a proud partner of Bruyère Continuing Care, the University of Ottawa and others and provides solutions to improve the health and health care of aging and vulnerable Canadians. The Institute’s research focuses primarily on evidence, health system evaluation, brain health, geriatrics and rehabilitation, primary care, palliative care and global health. www.bruyere.org/bri
For a media interview, please contact:
Eric Dicaire
Communications Assistant, Bruyère Research Institute
(613) 662 - 5932
edicaire@bruyere.org