A benzodiazepine discontinuation programme does not increase the frequency of contacts with the family practice

Gorgels, W.J.M.J.; Voshaar, Richard C. Oude; Mol, A.J.J.; Lisdonk, Eloy van de; Mulder, Jan De; Hoogen, Henk van den; Balkom, Anton van; Breteler, M.H.M.; Zitman, Frans G.

doi:10.1080/02813430801999121

Cited by 4 publications

(2 citation statements)

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“…Studies have shown that collaborative efforts to taper benzodiazepine use do not result in an increased workload for family physicians [48]. This type of approach could empower patients to participate in medication safety, diminish physician workload and do so at lower costs than current approaches in changing medical practice.…”

Section: Introductionmentioning

confidence: 99%

An educational intervention to reduce the use of potentially inappropriate medications among older adults (EMPOWER study): protocol for a cluster randomized trial

Martin

Tamblyn

Ahmed

et al. 2013

Trials

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BackgroundCurrently, far too many older adults consume inappropriate prescriptions, which increase the risk of adverse drug reactions and unnecessary hospitalizations. A health education program directly informing patients of prescription risks may promote inappropriate prescription discontinuation in chronic benzodiazepine users.Methods/DesignThis is a cluster randomized controlled trial using a two-arm parallel-design. A total of 250 older chronic benzodiazepine users recruited from community pharmacies in the greater Montreal area will be studied with informed consent. A participating pharmacy with recruited participants represents a cluster, the unit of randomization. For every four pharmacies recruited, a simple 2:2 randomization is used to allocate clusters into intervention and control arms. Participants will be followed for 1 year. Within the intervention clusters, participants will receive a novel educational intervention detailing risks and safe alternatives to their current potentially inappropriate medication, while the control group will be wait-listed for the intervention for 6 months and receive usual care during that time period. The primary outcome is the rate of change in benzodiazepine use at 6 months. Secondary outcomes are changes in risk perception, self-efficacy for discontinuing benzodiazepines, and activation of patients initiating discussions with their physician or pharmacist about safer prescribing practices. An intention-to-treat analysis will be followed.The rate of change of benzodiazepine use will be compared between intervention and control groups at the individual level at the 6-month follow-up. Risk differences between the control and experimental groups will be calculated, and the robust variance estimator will be used to estimate the associated 95% confidence interval (CI). As a sensitivity analysis (and/or if any confounders are unbalanced between the groups), we will estimate the risk difference for the intervention via a marginal model estimated via generalized estimating equations with an exchangeable correlation structure.DiscussionTargeting consumers directly as catalysts for engaging physicians and pharmacists in collaborative discontinuation of benzodiazepine drugs is a novel approach to reduce inappropriate prescriptions. By directly empowering chronic users with knowledge about risks, we hope to imitate the success of individually targeted anti-smoking campaigns.Trial registrationClinicalTrials.gov identifier: NCT01148186

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Section: Introductionmentioning

confidence: 99%

An educational intervention to reduce the use of potentially inappropriate medications among older adults (EMPOWER study): protocol for a cluster randomized trial

Martin

Tamblyn

Ahmed

et al. 2013

Trials

View full text Add to dashboard Cite

show abstract

“…The evidence must therefore often be sought from less strong data, such as observational studies, epidemiological research etc. However, discontinuation may prove to be possible [29]. It is our opinion that duration of drug therapy has received relatively little attention in the relevant literature, from RCTs to major textbooks.…”

Section: When To Stop?mentioning

confidence: 99%