Use of midazolam in hospitalized patients: analysis of medical practice.

Giroud M, Sellier E, Laval G.

Bull Cancer. 2013 Sep 1;100(9):811-817.

Source

CHU de Grenoble, unité de médecine palliative, 38043 Grenoble cedex 9, France.

Abstract

To evaluate the prevalence and the characteristics of use of midazolam among hospitalized patients and to analyze physicians' representation of this medicine. We conducted a retrospective study between 1st May and 22nd May 2011 in Grenoble University Hospital in France. All patients receiving midazolam during the study period were included, excepted if the prescription was performed in intensive care units, operating rooms or in pediatric units. Physicians from the different units were asked about the characteristics of patients receiving midazolam and about their practice concerning the use of midazolam. Forty-four patients were included, 82 % of whom having a cancer. The prevalence of prescription of midazolam was 3.3 % (44/1,323), 2.8 % (37/1,323) for anxiety relieving and 0.8 % (11/1,323) for sedation. The main refractory symptoms that justified the prescription were dyspnea (36.4 %), confusion (29.5 %), pain (27.3 %) and psychological suffering (27.3 %). Twenty-eight physicians were asked about their practice. The main representations of midazolam were the stop of active treatment (46.5 %) and premature cause of death (46.5 %).

 Practice of sedation is under-estimated by physicians as they have difficulties to differentiate anxiety relieving and sedation and they have difficulties to initiate a sedation. A guideline to help physicians using midazolam could improve practice.