Sleeping pills and sedatives: are older people in the West given sedatives too often?

PPeople in need of care living in houses in the old federal states are more likely to receive controversial sleeping pills and sedatives than in the new federal states. “Risky long-term prescriptions are much more common in the West than in the East,” the Federal Association of General Local Health Insurance Funds (AOK) and its Wido Scientific Institute said in Berlin on Tuesday.

In the worst quarter of cases assessed, nearly 10 percent of residents had such treatment, and in the best quarter, even 5 percent had such treatment, according to an analysis of billing data for AOK’s 2023 health care report. The average was 7.6 percent. 350 thousand residents aged 60 years and older were taken into account, this is about half of all inpatient care.

High values ​​in Saarland and North Rhine-Westphalia

Information obtained from eleven regional local health insurance companies in 400 districts and independent cities showed that long-term fund management is common throughout the Saarland, as well as in North Rhine-Westphalia (NRW), “where 45 of the 53 districts and independent cities show noticeable results.” Previously, there were repeated reports that those in need of help were given sedatives.

“In fact, people in need of care should be treated with sleeping pills and sedatives, tested for a maximum of four weeks,” said Antje Schwinger, head of nursing research at Wido. Long-term use can lead to addiction, increased risk of falls, anxiety, depression and aggression. “The evaluation of prescription data confirms the findings of numerous studies that there is a significant supply problem here that varies greatly from region to region.”

Ten links between caregiving and health were systematically examined. In the 2021 reporting year, nearly 4 percent of all dementia patients nationwide visited a nursing home due to insufficient fluid intake. In the 20 most prominent districts and cities it was up to 12.5 percent. Most of these occurred in Bavaria, Lower Saxony, Rhineland-Palatinate and North Rhine-Westphalia, as can be seen on AOK’s new online portal “Quality Atlas Care”.

There is good news about hospitalizations of nursing home residents in the last 30 days of their lives, which are often seen as unnecessary. Between 2017 and 2021, this value fell from 47 to 42 percent, although the effects of corona are unclear. Here too there was a divide between west and east. In Saarland in 2021 the figure was almost 50 percent, in Saxony only 36 percent.