Clinical Research Directory

Physical Activity Interventions for Sleep Improvement and Sedative-Hypnotic Reduction in Middle-Aged and Older Adults: Investigating the Role of Sarcopenia

Background: The prevalence of sedative-hypnotic use among middle-aged and older adults in Taiwan has continued to rise, highlighting the need to better understand the underlying factors contributing to sleep disturbances and medication dependence. Emerging evidence suggests that, beyond psychological and behavioral contributors, age-related physiological decline may play an important role. Sarcopenia, characterized by progressive loss of muscle mass and strength, is common in aging populations and has been linked to poor sleep quality, daytime fatigue, increased fall risk, and higher medication use. Regular physical activity not only improves symptoms of sarcopenia but has also been shown to enhance subjective sleep quality and modify objective sleep architecture, including increases in N3 slow-wave sleep. Despite these benefits, no study to date has directly examined whether physical activity can facilitate sedative-hypnotic dose reduction among chronic users. Purpose: The aim of this study is to investigate the associations among sarcopenia, sleep disturbances, and sedative-hypnotic use, and to evaluate the effectiveness of a structured physical activity intervention in improving subjective and objective sleep outcomes and promoting dose reduction in chronic hypnotic users. Methods: This three-year study will recruit 180 adults aged 50 years and older who have long-term sedative-hypnotic use. Participants will be randomly assigned to either an individualized 12-week physical activity program or a relaxation training control condition. Baseline and post-intervention assessments will include subjective sleep questionnaires, polysomnography, muscle strength and mass measurements, and standardized hypnotic dose quantification. Expected Results: Investigators anticipate that physical activity targeting muscle health will significantly improve sleep quality and contribute to meaningful reductions in sedative-hypnotic medication use among chronic users.

Nebulized Ketamine for the Treatment of Major Depressive Disorder

This is a double-blind active placebo controlled clinical trial for individuals with moderate to severe depression. The purpose of this study is to assess if nebulized ketamine can reduce depressive symptoms.

Cognitive Outcomes After Dexmedetomidine Sedation in Cardiac Surgery Patients

Anesthesia is a drug induced, reversible, comatose state that facilitates surgery and it is widely assumed that cognition returns to baseline after anesthetics have been eliminated. However, many patients have persistent memory impairment for weeks to months after surgery. Cardiac surgery appears to carry the highest risk of postoperative cognitive dysfunction (POCD). These cognitive deficits are associated with increased mortality, prolonged hospital stay and loss of independence. The investigators propose to investigate the role of Dexmedetomidine (DEX) in preventing long-term POCD after cardiac surgery and enhancing early postoperative recovery. It is anticipated that DEX will be the first effective preventative therapy for POCD, improve patient outcomes, and reduce length of stay and healthcare costs.

Patient-centred Deprescribing of Psychotropic, Sedative and Anticholinergic Medication in Elderly Patients With Polypharmacy

The PARTNER study is a multicentre, two-arm, pragmatic cluster-randomised trial evaluating the impact of a focused and patient-centred cooperation between general practitioners (GPs) and community pharmacists (PARTNER intervention) on reductions in the use of psychotropic, sedative and anticholinergic potentially inappropriate medication (PSA-PIM) compared to a control intervention. The PARTNER intervention comprises (1) education for health care professionals, (2) an interprofessional workshop and case conference, (3) a pharmacy visit with brown bag/medication review and patient empowerment, (4) GP practice visit with shared decision making. The control intervention only comprises a pharmacy visit with brown bag review.