Perioperative medicine & outcomes
Evaluation of a behavioural intervention to reduce perioperative midazolam administration to older adults
Main finding · Percentage of cases with midazolam administration, aged ≥70Result — go to the resultAdjusted difference-in-differences −3.2 percentage points 95% CI −5.2 to −1.1Authors' conclusion
Provider-facing alerts in the intraoperative electronic medical record, coupled with education, can reduce midazolam administration to older patients presenting for surgery but may affect care of younger patients.
Study context
- Population
- Older adults (≥70 y) undergoing surgery under GA at 5 hospitals of one US academic health systemcases aged ≥70
- Participants
- 20,347 adults
- Exposure
- Provider education plus automated EMR alert discouraging benzodiazepines (age ≥70) vs no intervention (4 comparator hospitals), 12 months before vs after
- Outcome
- Midazolam administration (percentage of cases) in patients aged 70 and older (primary analysis sample)
- Follow-up
- 12 months before and after intervention
Methodological detailsdifference-in-differences analysis, multicentre (5 hospitals), contemporaneous comparator hospitals
- Difference-in-differences analysis
- Multicentre (5 hospitals)
- Contemporaneous comparator hospitals
Main finding
As reported in the abstract
Percentage of cases with midazolam administration, aged ≥70
Adjusted difference-in-differences
−3.2 percentage points
95% CI −5.2 to −1.1
P = 0.002
Intervention
adjusted difference-in-differences −3.2 percentage points (95% CI −5.2 to −1.1); P = 0.002
- Intervention hospital: pre-alert vs post-alert, 454/4,240 (10.7%) vs 250/3,750 (6.7%)
- P < 0.001
- Comparator hospitals: 3,186/6,366 (50.0%) vs 2,935/5,991 (49.0%)
- P = 0.24
Observational data: associations, not effects.
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Evaluation of a behavioural intervention to reduce perioperative midazolam administration to older adults. BJA Open. Published 11 July 2023. doi:10.
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