title: Discontinuation of long-term benzodiazepine use by sending a letter to users in family practice: a prospective controlled intervention study.
abstract: Minimal intervention strategies to decrease long-term benzodiazepine use have not yet been evaluated in large primary care based studies with a blinded control condition and a long follow-up period. The purpose of this study was to assess the effects of a letter with a discontinuation advice sent to long-term benzodiazepine users in family practice followed by an evaluation consultation offer. The experimental group consisted of 2425 long-term benzodiazepine users, 1707 of whom were addressed by a discontinuation letter and an evaluation consultation offer. The control group consisted of 1821 long-term users. Primary endpoints were the number of prescribed daily dosages (PDD) and the percentage of subjects without prescription (quitters). At 21 months a reduction in benzodiazepine prescription of 26% was observed in the experimental group, versus 9% in the control group (PDD difference=12.5; 95%-ci: 8.2-16.8). In the experimental group 13% and in the control group 5% of the study completers were benzodiazepine prescription free through the full follow-up period (RR=2.6; 95%-ci: 2.0-3.4). The percentage of quitters at short-term (6 months) was 24% in the experimental group versus 12% in the control group (RR=2.1; 95%-ci: 1.8-2.4). It is concluded that this intervention strategy steadily reduces long-term benzodiazepine use in family practice.
authors.affiliation: Department of General Practice and Family Medicine, University Medical Centre St. Radboud, Nijmegen, The Netherlands. w.gorgels@hag.umcn.nl
authors.forename: Wim J M J
authors.initials: WJ
authors.lastname: Gorgels
authors.forename: Richard C
authors.initials: RC
authors.lastname: Oude Voshaar
authors.forename: Audrey J J
authors.initials: AJ
authors.lastname: Mol
authors.forename: Eloy H
authors.initials: EH
authors.lastname: van de Lisdonk
authors.forename: Anton J L M
authors.initials: AJ
authors.lastname: van Balkom
authors.forename: Henk J M
authors.initials: HJ
authors.lastname: van den Hoogen
authors.forename: Jan
authors.initials: J
authors.lastname: Mulder
authors.forename: Marinus H M
authors.initials: MH
authors.lastname: Breteler
authors.forename: Frans G
authors.initials: FG
authors.lastname: Zitman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000008:administration & dosage*; D015709:Correspondence as Topic; D005194:Family Practice / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D013995:Time
chemical_list: D001569:Benzodiazepines