Factors associated with high prescribing of benzodiazepines and minor opiates

Bjørner, Trine; Lærum, E

doi:10.1080/02813430310001734

Cited by 21 publications

(14 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast to studies on chronic usage, which have shown that patient demand was perceived to be a strong influencing factor for prescribing [16,38], GPs did not mention this as an element to initiate BZD treatment. The patient's demand might be a typical element of chronic usage due to the addictive nature of the drug once it has been introduced to the patient.…”

Section: Discussionmentioning

confidence: 99%

The lesser evil? Initiating a benzodiazepine prescription in general practice

Anthierens

Habraken²,

Petrovic

et al. 2007

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

Objective. Chronic benzodiazepine (BZD) use is widespread and linked with adverse effects. There is consensus concerning the importance of initiating BZD as a crucial moment. Nevertheless specific research in this field is lacking. This paper addresses the views of GPs on why they start prescribing BZDs to first-time users. Design. Qualitative study with five focus groups analysed using a systematic content analysis. Setting. Regions of Ghent and Brussels in Belgium. Subjects. A total of 35 general practitioners. Main outcome measure. The GPs' perspective on their initiating of BZD prescribing. Results. GPs reported that they are cautious in initiating BZD usage. At the same time, GPs feel overwhelmed by the psychosocial problems of their patients. They show empathy by prescribing. They feel in certain situations there are no other solutions and they experience BZDs as the lesser evil. They admit to resorting to BZDs because of time restraint and lack of alternatives. GPs do not perceive the addictive nature of BZD consumption as a problem with first-time users. GPs do not specifically mention patients' demand as an element for starting. Conclusion. The main concern of GPs is to help the patient. GPs should be aware of the addictive nature of BZD even in low doses and a non-pharmacological approach should be seen as the best first approach. If GPs decide to prescribe a BZD they should make plain to the patient that the medication is only a ''temporary'' solution with clear agreements with regard to medication withdrawal.

show abstract

Section: Discussionmentioning

confidence: 99%

The lesser evil? Initiating a benzodiazepine prescription in general practice

Anthierens

Habraken²,

Petrovic

et al. 2007

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

show abstract

“…Several studies have covered GPs' or psychiatrists' attitudes to and prescribing of BZD anxiolytics, BZD hypnotics and/or z-hypnotics (20,(58)(59)(60)(61)(62). At the time of initiating BZD prescription, some GPs seem to feel overwhelmed by the psychosocial problems of patients, and find BZDs to be "the lesser evil" (58).…”

Section: Antidepressantsmentioning

confidence: 99%

Use of anxiolytic or hypnotic drugs and total mortality in a general middle‐aged population

Hausken

Skurtveit

Tverdal

2007

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

PurposeThe aim of the study was to evaluate the effect of the consumption of anxiolytic or hypnotic drugs on total mortality in a general population.MethodsWe followed a cohort of 7225 men and 7726 women aged 40–42 years who underwent health surveys in 1985–1989 in two Norwegian counties, with respect to deaths. Mean follow‐up period was 18 years. The subjects were categorised according to frequency of anxiolytic or hypnotic drug use during the last month: daily, every week, less than every week and not used during the last month.ResultsThe proportion of anxiolytic or hypnotic drug users was 6.6% among men and 16.2% among women. Altogether 402 men and 290 women died. There was an increase in risk of death with an increase in frequency of use. Crude hazard ratios for men and women daily using anxiolytics or hypnotics were 3.1 (95%CI 2.0, 4.8) and 2.7 (1.9, 4.0), respectively, as compared with non‐users last month. After adjusting painkiller use and smoking the hazard ratios were lowered, being 2.4 (1.5–4.0) (men) and 2.1 (1.4–3.2) (women). After additional adjustments for other possible confounders the hazard ratios were further attenuated to 1.5 (0.9–2.7) for men and 1.7 (1.1–2.6) for women.ConclusionsDaily users of anxiolytic or hypnotic drugs in our study showed higher crude mortality than non‐users. However, after adjusting lifestyle and socio‐economic variables the difference was markedly reduced suggesting that the remaining excess mortality is due to residual confounding. Copyright © 2007 John Wiley & Sons, Ltd.

show abstract

“…This is partly explained by an increasing population, with an average growth per year of 0.4-0.5% since 1991 and an increasing proportion of older people. 8 Previous research has documented the attitudes of patients and doctors to benzodiazepines, [9][10][11][12][13][14][15] but little has so far been published about their perceptions or experiences of Z drugs, either alone or compared with benzodiazepine hypnotics. Studies of benzodiazepine hypnotics have shown that patients believe that they are more effective and safer than do doctors.…”

mentioning

confidence: 99%