Predictors of discontinuation of benzodiazepine prescription after sending a letter to long-term benzodiazepine users in family practice.
| Autor: | Gorgels WJ; Department of Psychiatry, Leiden University Medical Center, The Netherlands. W.Gorgels@hag.umcn.nl, Oude Voshaar RC, Mol AJ, van de Lisdonk EH, van Balkom AJ, Breteler MH, van den Hoogen HJ, Mulder J, Zitman FG |
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| Jazyk: | angličtina |
| Zdroj: | Family practice [Fam Pract] 2006 Feb; Vol. 23 (1), pp. 65-72. Date of Electronic Publication: 2005 Aug 17. |
| DOI: | 10.1093/fampra/cmi065 |
| Abstrakt: | Background: Predictors of benzodiazepine discontinuation after sending a discontinuation letter by the family practitioner have not been established sufficiently. Objective: To identify predictors of short- and long-term discontinuation of benzodiazepine use and relapse in use after a minimal intervention with a discontinuation letter followed by an offer for an evaluation consultation. Methods: Predictors of benzodiazepine discontinuation and relapse in use were studied by logistic regression analysis and survival analysis within a family practice population of long-term benzodiazepine users (n = 1707) addressed by a discontinuation letter and followed for 21 months. Results: A lower baseline prescription, a shorter duration of use, male gender and use of an agent with a half-life time <24 hours were predictive of complete discontinuation in the short (6 months) and long term (21 months). Multiple agent use at baseline, use of antidepressants at 6 months and benzodiazepine type (anxiolytic/hypnotic) at baseline predicted relapse. Attendance at an evaluation consultation 3 months after the letter was sent was not predictive of discontinuation or relapse. Conclusions: Amount of baseline use and duration of use are the main determinative characteristics of successful discontinuation. The discontinuation letter intervention is suitable for use with a broad group of long-term benzodiazepine users in family practice and can be used as a first step within a stepped care approach to decrease long-term benzodiazepine use. |
| Databáze: | MEDLINE |
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