Brief Intervention for Sleep Medication Misuse Among Elderly

NCT ID: NCT06032715

Last Updated: 2024-11-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-09

Study Completion Date

2025-06-30

Brief Summary

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Randomized controlled trial to evaluate effectiveness of behavioral Brief Intervention administered by General practitioners (GPs) versus business as usual on use of Z-hypnotics by elderly patients in primary care.

Detailed Description

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Two armed study with controlled masked first part over 6 months. Active arm is with Brief Intervention for inappropriate use of Z-hypnotics among elderly with intervention delivered by trained GPs. Control arm is for patients handled by their (non-trained) GPs with business as usual (BAU). Main outcome is 6 weeks after intervention with additional data collection points after 6 months (blinded) and long-term follow-up to 12 months (open). After 6 months there will be an open single crossover as BAU GPs will then also receive training in the Brief Intervention method.

Baseline assessments are limited to self reports and automatic sleep assessment with actigraphy to avoid assessment effects. Follow-up at main outcome time point is in person, some outcomes are also by telephone assessment and compared to baseline prior to intervention (e g Actigraphy assessment.

Conditions

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Harmful Use of Hypnotic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel masked and controlled first part intervention vs Business as usual with follow-up after 6 months by masked assessors. Subsequently open single cross-over of business as usual patients to also receive the same intervention.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
GPs will be cluster randomized based on GP to two sequential teaching programs to learn the Brief Intervention procedure. The patients of those who have the course first will constitute the intervention arm while patients of GPs who are in the second course will constitute parallel business as usual controls in the masked part of the study. When the second group of GPs have their course, open cross-over will be possible.

Study Groups

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BI (Brief Intervention)

Patients whose GPs have been taught the behavioral BI intervention aiming to reduce prolonged use of Z-hypnotics.

Group Type ACTIVE_COMPARATOR

BI (Brief Intervention)

Intervention Type BEHAVIORAL

Short structured individual behavioral intervention to reduce inappropriate usage of Z-hypnotics

BAU (Business as usual)

Patients whose GPs have not yet been taught the BI intervention. Patients only assessed in parallel with BI group by masked assessors using same instruments as for active comparator.

This group also constitutes an open cross-over group to active intervention once the masked 6 months phase is completed.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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BI (Brief Intervention)

Short structured individual behavioral intervention to reduce inappropriate usage of Z-hypnotics

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Self-reported use of Z-hypnotics \> 4 days per week and \> 4 weeks

Exclusion Criteria

* diagnosis of dementia,
* diagnosis of psychosis,
* diagnosis of major depression,
* diagnosis of delirium,
* unable to give informed consent,
* insufficient Norwegian language capacity to complete tests
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oslo

OTHER

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role lead

Responsible Party

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Christofer Lundqvist

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christofer Lundqvist, MD, PhD

Role: STUDY_CHAIR

Akershus University Hospital and University of Oslo

Locations

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Akershus University Hospital

Lørenskog, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Tahreem G Siddiqui, PhD

Role: CONTACT

90600984 ext. +47

Facility Contacts

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C Lundqvist, MD, PhD

Role: primary

References

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Kristoffersen ES, Straand J, Vetvik KG, Benth JS, Russell MB, Lundqvist C. Brief intervention for medication-overuse headache in primary care. The BIMOH study: a double-blind pragmatic cluster randomised parallel controlled trial. J Neurol Neurosurg Psychiatry. 2015 May;86(5):505-12. doi: 10.1136/jnnp-2014-308548. Epub 2014 Aug 11.

Reference Type BACKGROUND
PMID: 25112307 (View on PubMed)

Frich JC, Kristoffersen ES, Lundqvist C. GPs' experiences with brief intervention for medication-overuse headache: a qualitative study in general practice. Br J Gen Pract. 2014 Sep;64(626):e525-31. doi: 10.3399/bjgp14X681313.

Reference Type BACKGROUND
PMID: 25179065 (View on PubMed)

Kristoffersen ES, Straand J, Vetvik KG, Benth JS, Russell MB, Lundqvist C. Brief intervention by general practitioners for medication-overuse headache, follow-up after 6 months: a pragmatic cluster-randomised controlled trial. J Neurol. 2016 Feb;263(2):344-353. doi: 10.1007/s00415-015-7975-1. Epub 2015 Dec 8.

Reference Type BACKGROUND
PMID: 26645391 (View on PubMed)

Kristoffersen ES, Straand J, Russell MB, Lundqvist C. Lasting improvement of medication-overuse headache after brief intervention - a long-term follow-up in primary care. Eur J Neurol. 2017 Jul;24(7):883-891. doi: 10.1111/ene.13318. Epub 2017 May 23.

Reference Type BACKGROUND
PMID: 28544265 (View on PubMed)

Cheng S, Siddiqui TG, Gossop M, Kristoffersen ES, Lundqvist C. The Severity of Dependence Scale detects medication misuse and dependence among hospitalized older patients. BMC Geriatr. 2019 Jun 24;19(1):174. doi: 10.1186/s12877-019-1182-3.

Reference Type BACKGROUND
PMID: 31234786 (View on PubMed)

Siddiqui TG, Cheng S, Gossop M, Kristoffersen ES, Grambaite R, Lundqvist C. Association between prescribed central nervous system depressant drugs, comorbidity and cognition among hospitalised older patients: a cross-sectional study. BMJ Open. 2020 Jul 27;10(7):e038432. doi: 10.1136/bmjopen-2020-038432.

Reference Type BACKGROUND
PMID: 32718926 (View on PubMed)

Siddiqui TG, Cheng S, Mellingsaeter M, Grambaite R, Gulbrandsen P, Lundqvist C, Gerwing J. "What should I do when I get home?" treatment plan discussion at discharge between specialist physicians and older in-patients: mixed method study. BMC Health Serv Res. 2020 Nov 3;20(1):1002. doi: 10.1186/s12913-020-05860-9.

Reference Type BACKGROUND
PMID: 33143713 (View on PubMed)

Bjelkaroy MT, Cheng S, Siddiqui TG, Benth JS, Grambaite R, Kristoffersen ES, Lundqvist C. The association between pain and central nervous system depressing medication among hospitalised Norwegian older adults. Scand J Pain. 2021 Dec 16;22(3):483-493. doi: 10.1515/sjpain-2021-0120. Print 2022 Jul 26.

Reference Type BACKGROUND
PMID: 34913326 (View on PubMed)

Siddiqui TG, Bjelkaroy MT, Cheng S, Kristoffersen ES, Grambaite R, Lundqvist C. The effect of cognitive function and central nervous system depressant use on mortality-A prospective observational study of previously hospitalised older patients. PLoS One. 2022 Mar 3;17(3):e0263024. doi: 10.1371/journal.pone.0263024. eCollection 2022.

Reference Type BACKGROUND
PMID: 35239678 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan: Statistical analysis plan screening data

View Document

Document Type: Statistical Analysis Plan: Statistical analysis plan main RCT

View Document

Related Links

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https://apps.who.int/iris/handle/10665/44320

Humeniuk et al (2010), WHO: The Alcohol, Smoking and Substance involvement Screening Test (ASSIST): manual for use in primary care

https://apps.who.int/iris/handle/10665/67210

Babor et al (2001), WHO: Brief intervention for hazardous and harmful drinking : a manual for use in primary care

Other Identifiers

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BI-sleep

Identifier Type: -

Identifier Source: org_study_id

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