RT Journal Article
SR Electronic
T1 Efficacy of two interventions on the discontinuation of benzodiazepines in long-term users: 36-month follow-up of a cluster randomised trial in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e85
OP e91
DO 10.3399/bjgp16X683485
VO 66
IS 643
A1 Caterina Vicens
A1 Ermengol Sempere
A1 Ferrán Bejarano
A1 Isabel Socias
A1 Catalina Mateu
A1 Francisca Fiol
A1 Vicente Palop
A1 Marta Mengual
A1 Silvia Folch
A1 Guillem Lera
A1 Josep Basora
A1 Alfonso Leiva
YR 2016
UL http://bjgp.org/content/66/643/e85.abstract
AB Background Primary care interventions that promote cessation of benzodiazepine (BZD) use in long-term users are effective at 1 year, but their efficacy at 3 years is uncertain.Aim To assess the 3-year efficacy of two primary care interventions delivered by GPs on cessation of BZD use in long-term users.Design and setting Multicentre, three-arm, cluster randomised, controlled trial, with random allocation at the GP level.Method Seventy-five GPs and 532 patients were randomly allocated to three groups: usual care (control), structured intervention with stepped-dose reduction and follow-up visits (SIF), or structured intervention with written stepped-dose reduction (SIW). The primary outcome was BZD use at 36 months.Results At 36 months, 66/168 patients (39.2%) in the SIW group, 79/191 patients (41.3%) in the SIF group, and 45/173 patients (26.0%) in the control group had discontinued BZD use. The relative risks (RR) adjusted by cluster were 1.51 (95% CI = 1.10 to 2.05; P = 0.009) in the SIW group and 1.59 (95% CI = 1.15 to 2.19; P = 0.005) in the SIF group. A total of 131/188 patients (69.7%) who successfully discontinued BZD use at 12 months remained abstinent at 36 months. The groups showed no significant differences in anxiety, depression, or sleep dissatisfaction at 36 months.Conclusion The interventions were effective on cessation of BZD use; most patients who discontinued at 12 months remained abstinent at 3 years. Discontinuation of BZD use did not have a significant effect on anxiety, depression, or sleep quality.