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Trial Lecture – time and place
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Adjudication committee
- First opponent: Associate Professor Susanne Sørensen Hernes, University of Bergen
- Second opponent: Assistant Professor Frank Vitinius, Department of Psychosomatics and Psychotherapy, University Hospital of Cologne
- Third member and chair of the evaluation committee: Professor II Nada Andelic, University of Oslo
Chair of the Defence
Professor Ole Morten Rønning, Faculty of Medicine, University of Oslo
Principal Supervisor
Professor Christofer Lundqvist, Faculty of Medicine, University of Oslo
Summary
Central nervous system depressant medications (CNSD) such as Z-hypnotics, Benzodiazepines and opioid analgesics are commonly used among older adults. They are often prescribed to relieve symptoms associated with insomnia, anxiety disorders and pain conditions. CNSD are recommended to be used with caution and for short periods among older patients in relation to indication. Prolonged use can lead to adverse events related to CNSD. To avoid negative health outcomes, it is important to follow the treatment plan after discharge. Thus, the aim of this thesis was to examine the relationship between CNSD use, cognitive function, mortality and communication with older patients about their treatment plan.
This thesis consists of three studies. The first study had a cross-sectional design, examining the association between cognitive function and CNSD. The second study was a mixed method study on discharge conversation, regarding the treatment plan between physicians and older patients. The third study was a prospective follow-up study, assessing the effect of reduced cognitive function and CNSD use on mortality two years after discharge from hospital.
The results indicated that prolonged CNSD users had reduced cognitive function compared to non-users. Comorbidity was associated with reduced cognitive function. Mortality two years after discharge from hospital was associated with CNSD use and reduced cognitive function. Patients leaving the hospital discussed their treatment plan largely about their medications (e.g., continuing, stopping, increasing, or reducing the prescription). Around half of the regularly used medications were discussed, but adverse effects of medications were rarely mentioned.
More frequent and careful medication evaluation in older patients with multiple medication use is needed. Using communication strategies and other non-pharmacological methods to reduce CNSD use might be beneficial for the long-term outcomes in older patients.
Additional information
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