Interventions to improve benzodiazepine tapering success in the elderly: a systematic review

Abstract

Patient education is a successful, time- and cost-effective intervention that can significantly help with benzodiazepine discontinuation success. CBT may also be an effective approach. However, cost can be an issue since public healthcare coverage in Canada does not cover psychotherapy. More research is needed in looking at pharmaceutical adjuvants and their role in assisting with benzodiazepine discontinuation.

De-prescribing benzodiazepine receptor agonists taken for insomnia: a review and key messages from practice guidelines

“…38 In a recent systematic review of interventions to improve benzodiazepine tapering success, a meta -analysis of 3 RCTs (779 participants in total) evaluating tapering combined with patient education demonstrated a significant increase in the odds of BZRA cessation compared with usual care (odds ratio, 5.94; 95% CI, 3.99-8.83). 45 RCTs have also shown that simple interventions that focus on patient empowerment and self -management have been successful in benzodiazepine deprescribing. 46,47 Interventions can motivate by focusing not only on the risks of continued use, but the potential benefits of stopping (eg, less daytime fatigue).…”

Missbrauch und Abhängigkeit von Benzodiazepinen und Z-Drugs

“…Basierend auf dem transtheoretischen Model von Prochaska und DiClemente [126] wurde das "motivational interviewing" entwickelt [127], das verschiedene Phasen der Willensbildung und Veränderungsbereitschaft beschreibt. Man kann dies auch auf die Therapie von Medikamentenabhängigen übertragen, aber es sind nur wenige Befunde verfügbar [115].…”

Raising Awareness Regarding Appropriate Benzodiazepine Use

“…Cartas ao Editor, Acta Med Port 2021 Jul-Aug;34(7-8):562-565 Sónia FARINHA-SILVA 1 , Paulo REIS-PINA 2,3…”

“…Although BZDs are approved for short-term treatment, its long-term use is common and recognized as a relevant public health problem. 2 There are reports stating that the long-term consumption increased in recent decades especially in older age. 3 In Europe, the level of consumption is high, and, Portugal has one of the highest levels of consumption of BZDs when compared with other European countries.…”

“…Patient education combined with a tapering schedule lead to significant increase in discontinuation success. 2 It is important to implement prevention programs for appropriate BZD use and to motivate patients with chronic consumption to participate in BZD discontinuation. It is also necessary to develop guidelines to help general practitioners manage these situations and to identify and better treat depression and anxiety in the community.…”