Standardization of Inpatient Insomnia Medications as a Potential Strategy to Reduce Outpatient Benzodiazepine Receptor Agonist Prescriptions

Introduction Insomnia is a common clinical complaint, often presenting with symptoms such as difficulty initiating sleep, frequent nighttime awakenings, early morning awakenings, or non-restorative sleep. These disturbances are frequently associated with a range of psychiatric and physical conditions and may contribute to reduced quality of life and broader societal burden. Although benzodiazepines (BZ) are commonly used to manage inpatient insomnia, their use, especially in older adults, has been associated with adverse outcomes such as cognitive impairment, falls, and fractures. In an effort to promote safer prescribing practices, Hiroshima University Hospital revised its inpatient formulary and clinical pathway guidance in November 2021 to discourage the initiation of new BZRA prescriptions during hospitalization. Methods We conducted a retrospective review of medical records to analyze hypnotic prescriptions in outpatients, using descriptive statistical methods. This analysis evaluated the effect of standardizing inpatient insomnia medications on trends in physicians' hypnotic prescriptions for outpatients. Results The findings showed a decrease in prescription rates for BZ and non-BZ drugs during the study period. In addition, a decreasing trend was observed for new prescriptions of BZ receptor agonists over the three-month period. Conclusions It was suggested that restricting the prescription of BZ for insomnia in inpatient settings could facilitate the appropriate prescription of insomnia medications for outpatients by clinicians.