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Fam Pract. 2006 Feb;23(1):65-72. Epub 2005 Aug 17.

Predictors of discontinuation of benzodiazepine prescription after sending a letter to long-term benzodiazepine users in family practice.

Author information

1
Department of Psychiatry, Leiden University Medical Center, The Netherlands. W.Gorgels@hag.umcn.nl

Abstract

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.

PMID:
16107495
DOI:
10.1093/fampra/cmi065
[Indexed for MEDLINE]

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