Reducing Sleep Pill Use in Elderly: Patients & Caregivers Involved

The European project BE-SAFE, in which the Fundació Salut i Envelliment – UAB participates, will implement an evidence-based method focused on patients that helps reduce the use of benzodiazepines and sedative-hypnotics among older people and improves the quality of their care and safety. To promote a comprehensive approach to this problem, the project involves experts, caregivers, and affected people through the constitution of an international patient advisory council.

Despite current evidence, the use of benzodiazepines, sedatives and hypnotics (BSH) is common, particularly among people older than 65 years with an active diagnosis of insomnia in countries like the US and European countries. But there is evidence that prolonged use of these treatments, especially when they have an effect with a medium or long-term life, carries risks, such as cognitive decline, falls and traffic accidents, which means an increase in hospitalizations and mortality. According to experts, in view of the risks compared to the benefits, the long-term routine prescription of these drugs in older people should not be a first option and one should opt for approaches based, first of all, on an improvement in sleep hygiene and, if appropriate, by interventions based on cognitive behavioral therapy.

In this context, six organizations (universities, hospitals and European institutions), including the Fundació Salut i Envelliment – UAB, are carrying out the BE-SAFE project, to provide a comprehensive understanding of the use of sleep medications from different perspectives and develop a method to reduce its use in senior citizens. To this end, they have recently set up a Patient Advisory Council (PAC) from six previously formed local councils (Belgium, Spain, Norway, Greece, Switzerland, and Poland), made up of patients, caregivers, users and senior citizens organizations, who advise on all aspects of the project.

“The objective of the PAC is to guarantee a true and equitable representation of the voice of patients and carers within the project, and to collect the opinions, preferences, needs and expectations of older people who use sleeping pills, to improve their safety and care”, explains Dr. Anne Spinewine, coordinator of the BE-SAFE project from Université catholique de Louvain (Brussels, Belgium). “From the project consortium, we make our own the theme of World Sleep Day, which considers sleep essential for health and key to involve all the actors in the development and implementation of actions that improve the quality of sleep of older people”, adds Dr. Antoni Salvà, director of Fundació Salut i Envelliment – UAB, institution in charge of coordinating the constitution of the council.

Among the research activities that the PAC will contribute with is a survey among patients, caregivers and health professionals to identify variables that facilitate or impede the reduction in the use of this sleep medication. Based on these results, the BE-SAFE consortium will develop a method to reduce the use of these drugs against sleep problems and will contribute to the development of recommendations and educational materials for patients and caregivers.

In the most advanced phase of the project, the six countries of the member organizations will test the approach by developing a clinical trial. The PAC will participate throughout the process of creating tools to disseminate best practices and the implementation of the resulting method in other European health systems.

With a duration of five years (2022-2027), the project is led by the Université catholique of Louvain (Belgium). In addition to the Fundació Salut i Envelliment – UAB, the Institute of Psychiatry and Neurology (IPIN) of Poland, the University Hospital of Oslo (OUS), the MAGIC Evidence Foundation Ecosystem from Norway, and the National and Capodistrian University of Athens, from Greece, will all be participating in the project.

BE-SAFE is funded by the European Commission within the framework of the HORIZON-HLTH-2021-CARE-05-01 programme: Improvement of the quality of care and patient safety, and by the Secretary of State for Education, Research and innovation (SERI) (contract no. 22.00116) of Ottawa Hospital Research Institute (OHRI) and Choosing Wisely (

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