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Off‐label use of midazolam in older inpatients: analysis of prescribing practices in a French hospital (MIDnight study)
Author(s) -
Michelon Hugues,
PonsPeyneau Cécile,
Gourdon Mathilde,
Le Dastumer Bruno,
Teillet Laurent,
Herr Marie
Publication year - 2020
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/fcp.12532
Subject(s) - midazolam , medical prescription , medicine , sedation , benzodiazepine , premedication , adverse effect , sedative , geriatrics , hypnotic , anesthesia , intensive care medicine , psychiatry , pharmacology , receptor
Midazolam is a short‐acting benzodiazepine approved for sedation and anesthesia induction. Recent data suggested that midazolam may also be used in off‐label indications such as treatment of behavioral and psychological disturbances in older people. Given the scarcity of published data and a lack of evidence in older people in such indications, midazolam raises concern because it may also cause serious‐related adverse events. To provide a better understanding of its real‐life use in geriatrics, we examined the prescribing practices of midazolam in French older inpatients. Of the 460 patients aged 65 years and over hospitalized at the time of the study, 21 had a prescription of midazolam (5%) which was mainly prescribed for anxiolysis ( n = 12), premedication before painful procedures ( n = 5), and agitation ( n = 4). Midazolam was often prescribed “as required,” and the median duration of prescription was 6 months. This work results in a better knowledge and information about the use of midazolam in older people. These prescribing practices, which are not anecdotal, also plead for age‐specific guidelines for the treatment of behavioral and psychological disturbances.