# Mitigating Benzodiazepine and Sedative Use in the Hospital through Inpatient Deprescribing

> **NIH NIH R01** · CEDARS-SINAI MEDICAL CENTER · 2020 · $172,546

## Abstract

The sickest patients in the community are recently hospitalized elders. A substantial component of their
morbidity and mortality is caused by adverse drug events (ADEs). ADEs account for 70% of adverse events
occurring after discharge, which occur at a rate of 0.30 ADEs per patient. The oldest, sickest patients are at
highest risk for ADEs because they have the most complex and hazardous medication regimens yet the least
physiologic reserve and the fewest social and economic resources.
 Several studies, including our own, have demonstrated the efficacy of pharmacist-led post-discharge
interventions to improve medication management. Most prominent among these have been post-discharge
phone calls from pharmacists to patients. However, despite demonstrated efficacy, these interventions have
not been widely implemented. In this proposal, we use the RE-AIM model to understand and address gaps in
existing research that have hindered implementation. The central knowledge gap is that most research
focuses on process or surrogate endpoint measures (like medication discrepancies) that we now understand to
be insufficient to motivate organizational change. In contrast, we will measure the effect on utilization, a
closely-tracked outcome that strongly motivates hospital leaders. We will use a large randomized controlled
trial to rigorously assess the effect of PHARM-DC on this outcome. We will also study the barriers and
facilitators of adopting these interventions, about which little is known. Finally, although implementation costs
are critically important information for organizations considering pharmacist-led discharge (PHARM-DC)
interventions, evidence on this topic is scarce. We thus aim to measure the impact of PHARM-DC
interventions on post-discharge utilization within 30 days. We will also identify patient sub-populations most
likely to benefit from PHARM-DC. Finally, we will estimate the incremental net cost of PHARMs from the
health system perspective.
 To study these aims, we have selected two sites that: 1) are already proficient at in-hospital medication
reconciliation, a prerequisite for implementing and evaluating PHARM-DC; 2) have a Chief Pharmacy Officer
committed to using operational resources to provide PHARM-DC to patients during the study period; and 3)
have investigators experienced in the research content and methodologies needed to study the
aforementioned aims.
 This project will generate new knowledge allowing for increased implementation and dissemination of
research already known to be efficacious, thus reducing the substantial morbidity and mortality attributable to
ADEs among seniors in the high risk post-discharge time period.

## Key facts

- **NIH application ID:** 10076575
- **Project number:** 3R01AG058911-03S1
- **Recipient organization:** CEDARS-SINAI MEDICAL CENTER
- **Principal Investigator:** Joshua M Pevnick
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $172,546
- **Award type:** 3
- **Project period:** 2018-09-01 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10076575

## Citation

> US National Institutes of Health, RePORTER application 10076575, Mitigating Benzodiazepine and Sedative Use in the Hospital through Inpatient Deprescribing (3R01AG058911-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10076575. Licensed CC0.

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