Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand.
BACKGROUND
Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand.


METHODS
Questionnaire survey of general practitioners in community hospitals, to estimate: i) use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii) views on the optimal duration of benzodiazepine use.


RESULTS
Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%), panic disorder (n = 43, 78%), depression (n = 26, 43%), essential hypertension (n = 15, 27 %) and uncomplicated low back pain (n = 10, 18%). Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%); or from 1 week to 1 month (47%); or 1 to 4 months (16%); or 4 to 6 months (5%) or more than 6 months (2%). Twenty-five general practitioners (45%) accepted that they used benzodiazepines excessively in the past year.


CONCLUSIONS
A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.
Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Amphur Muang, Chiang Mai, 50200, Thailand. msrisura@mail.med.cmu.ac.th
Manit
M
Srisurapanont
Paul
P
Garner
Julia
J
Critchley
Nahathai
N
Wongpakaran
D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001569:Benzodiazepines / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005194:Family Practice / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006300:Health Services Misuse; D006764:Hospitals, Community; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013785:Thailand
D014151:Anti-Anxiety Agents; D009465:Neuromuscular Agents; D001569:Benzodiazepines