The lesser evil? Initiating a benzodiazepine prescription in general practice: a qualitative study on GPs' perspectives.
OBJECTIVE
Chronic benzodiazepine (BZD) use is widespread and linked with adverse effects. There is consensus concerning the importance of initiating BZD as a crucial moment. Nevertheless specific research in this field is lacking. This paper addresses the views of GPs on why they start prescribing BZDs to first-time users.


METHODS
Qualitative study with five focus groups analysed using a systematic content analysis.


METHODS
Regions of Ghent and Brussels in Belgium.


METHODS
A total of 35 general practitioners.


METHODS
The GPs' perspective on their initiating of BZD prescribing.


RESULTS
GPs reported that they are cautious in initiating BZD usage. At the same time, GPs feel overwhelmed by the psychosocial problems of their patients. They show empathy by prescribing. They feel in certain situations there are no other solutions and they experience BZDs as the lesser evil. They admit to resorting to BZDs because of time restraint and lack of alternatives. GPs do not perceive the addictive nature of BZD consumption as a problem with first-time users. GPs do not specifically mention patients' demand as an element for starting.


CONCLUSIONS
The main concern of GPs is to help the patient. GPs should be aware of the addictive nature of BZD even in low doses and a non-pharmacological approach should be seen as the best first approach. If GPs decide to prescribe a BZD they should make plain to the patient that the medication is only a "temporary" solution with clear agreements with regard to medication withdrawal.
Department of General Practice and Primary Health Care, Ghent University, Gent, Belgium. sibyl.anthierens@ugent.be
Sibyl
S
Anthierens
Hilde
H
Habraken
Mirko
M
Petrovic
Thierry
T
Christiaens
D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects; D002755:Choice Behavior; D011307:Drug Prescriptions; D004645:Empathy; D005194:Family Practice; D017144:Focus Groups; D006801:Humans; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires
D014151:Anti-Anxiety Agents; D001569:Benzodiazepines