Document Detail


Assessment of hypnotic effects and patient satisfaction in empirical use of sleep medicines.
MedLine Citation:
PMID:  18452414     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We assessed the hypnotic effects of and patient satisfaction with three types of hypnotics prescribed empirically: ultra-short-acting (US-a), short-acting (S-a), and intermediate- and long-acting (IL-a) agents. METHODS: We studied 310 insomniac patients (age 60.5 +/- 15.0 years) treated with US-a (n = 124), S-a (n = 149) or IL-a (n = 37) agents. Patients were interviewed to evaluate individual satisfaction and drug efficacy. Efficacy, as assessed by total sleep time (TST) and sleep latency time (SLT), was compared between satisfied and dissatisfied patient groups. Nocturnal awaking curve for each hypnotic was used for comparing the effects between satisfied and dissatisfied patient groups in each type of hypnotics. RESULTS: Thirty-two patients (25.8%) were dissatisfied with US-a, 35 (23.5%) with S-a and 11 (29.7%) with IL-a. TST differed significantly between satisfied and dissatisfied groups: 424 +/- 88 vs. 345 +/- 101 min for US-a (P < 0.001), 440 +/- 84 vs. 359 +/- 111 min for S-a (P < 0.001) and 453 +/- 96 vs. 345 +/- 125 min for IL-a (P < 0.01), respectively. With IL-a agents, the SLT of dissatisfied patients was longer than in satisfied ones (81 +/- 52 vs. 33 +/- 22 min, P < 0.05). Twenty (62.5%) dissatisfied patients taking US-a agents awoke before 05:00 hours - a rate significantly higher than satisfied patients (n = 23, 25.0%, P < 0.001). These characteristics of dissatisfied patients were reflected by the patterns of nocturnal awaking curves, although the patterns for satisfied patients were similar among the three types of hypnotics. CONCLUSION: Between 24% and 30% of patients were dissatisfied with their hypnotics. Shorter TST was common in dissatisfied patients receiving any agent, for reasons differing among hypnotics (longer SLT with IL-a agents and early awakening with US-a). Drug efficacy and patient satisfaction in empirical use of hypnotics can be assessed by nocturnal awaking curves for each hypnotic.
Authors:
T Yamashiro; M Homma; Y Kohda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  33     ISSN:  1365-2710     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-02     Completed Date:  2008-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  273-8     Citation Subset:  IM    
Affiliation:
Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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MeSH Terms
Descriptor/Qualifier:
Delayed-Action Preparations
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Hospitals, University
Humans
Hypnotics and Sedatives / administration & dosage,  therapeutic use*
Interviews as Topic
Male
Middle Aged
Patient Satisfaction*
Sleep / drug effects
Sleep Initiation and Maintenance Disorders / drug therapy*
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Hypnotics and Sedatives

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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