# Re-Audit of Discontinuation Plans on Discharge for Prescribed Hypnotics in General Adult Inpatient Services

## TL;DR

This study found that only 18.75% of patients discharged from psychiatry wards had specific hypnotic discontinuation plans, but improvements were seen after implementing changes.

## Contribution

The study demonstrates the effectiveness of implementing changes to improve documentation of hypnotic discontinuation plans in discharge summaries.

## Key findings

- Only 18.75% of discharge summaries included a specific hypnotic discontinuation plan.
- A re-audit showed significant improvement in compliance with recommendations after changes were implemented.
- Strict adherence to guidelines is needed to achieve full compliance and reduce hypnotic risks.

## Abstract

Aims: Assess the number of patients discharged from General Adult Psychiatry wards with hypnotics prescribed for insomnia.

Evaluate the consistency of documenting discontinuation plans for hypnotics in discharge summaries.

Methods: We conducted a retrospective review of 24-hour discharge summaries for patients discharged from six adult inpatient general psychiatry wards between 15/01/2024 and 15/04/2024. The review focused on patients prescribed regular hypnotics for insomnia, specifically analysing the “Instructions to GP” section to determine whether a specific discontinuation plan was recommended or advised. This was done by reviewing our online database used within the trust.

Results: In the current audit, 56.25% of the sample had discharge summaries that included a medication review for hypnotics suggested to the GP, while only 18.75% included a specific discontinuation plan for hypnotic medication. A previous audit conducted in 2023 on two adult inpatient general psychiatry wards demonstrated 0% compliance, with no discharge summaries containing a medication review for hypnotics or a specific discontinuation plan. Following the implementation of changes, a re-audit in 2024 on the same wards showed significant improvement, with 66.6% of discharge summaries including a medication review for hypnotics and 33.3% containing a specific discontinuation plan for hypnotic medication.

Conclusion: The previous recommendations have led to noticeable improvements; however, strict adherence to these recommendations is necessary to achieve the target of 100% compliance. It is crucial for the inpatient General Adult Psychiatry team to consistently communicate a specific discontinuation plan for hypnotics to the GP. This practice is essential to reduce the risk of dependence and minimize potential side effects associated with hypnotic medications.

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Source: https://tomesphere.com/paper/PMC12260660