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Zolpidem taken in hospital increases chance of falling

Monday November 19, 2012
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A drug commonly prescribed to help patients sleep in hospitals has been associated with an increased risk of falls, according to a study.

Sleep specialists from the Mayo Clinic found that the fall rate among 4,962 patients who took zolpidem during their hospital stay was more than four times as high as among the 11,358 who did not take the drug.

They also found that the risk posed by the drug was greater than the risks posed by factors such as age, cognitive impairment, delirium or insomnia, regardless of the dosage.

"Ensuring that people get enough sleep during their hospital stay is very important, but it can also prove very challenging," Timothy I. Morgenthaler, MD, the Mayo Clinic’s chief patient safety officer and a specialist in sleep disorders and pulmonary and critical care, said in a news release.

"Patient falls are also a significant patient safety issue in hospitals and one that has been quite difficult to tackle, despite considerable efforts. … Discovering that zolpidem, which is commonly used in most hospitals, is a significant risk factor for patient falls provides us with additional knowledge to help tackle this problem."

Just more than 3% of the patients on zolpidem fell during their inpatient hospital stay, compared with 0.7% of patients who did not take zolpidem. The drug continued to be associated with an increased fall risk when other key factors, including health, length of hospital stay and assessed fall risk, were taken into consideration.

"Our hospitals have an overall fall rate of about 2.5 per 1,000 patient days, which is lower than many national benchmarks," Morgenthaler said. "However, we have not been able to significantly reduce this rate in recent years. Now, we calculate that for every 55 patients who received zolpidem, there was one additional fall that may have been avoided by not administering the drug."

"As a result of our study, we are now phasing out zolpidem and moving toward sleep enhancement techniques that are not based on drug and which we believe are safer and probably as effective."

The study appeared Nov. 19 on the website of the Journal of Hospital Medicine. The study abstract is available at http://onlinelibrary.wiley.com/doi/10.1002/jhm.1985/abstract.


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