Authors: Mugunthan, Kayalvili; McGuire, Treasure; Glasziou, Paul

Source: British Journal of General Practice, Volume 61, Number 590, September 2011 , pp. e573-e578(6)

Publisher: Royal College of General Practitioners

Abstract:

Background

Long-term use of benzodiazepines (BZDs) is common. Not only is such use ineffective, but it also has several risks in addition to dependence, and remains a significant problem among the older population

Aim

To systematically review randomised controlled trials that evaluate the effectiveness of minimal interventions to reduce the long-term use of BZDs in primary care.

Design and setting

Systematic review and meta-analysis of randomised controlled trials in UK general practices.

Method

Cochrane Central, MEDLINE, and Embase (1967-2010) were searched for trials of minimal interventions (such as a single letter or one consultation from a GP) for patients in primary care with long-term (>3 months) BZD use. Pooled risk differences were calculated with 95% confidence intervals.

Results

From 646 potentially relevant abstracts, three studies (615 patients) met all the inclusion criteria. The pooled risk ratio showed a significant reduction/cessation in BZD consumption in the minimal intervention groups compared to usual care (risk ratio [RR] = 2.1, 95% confidence interval [CI] = 1.5 to 2.8, P<0.001; RR = 2.04, 95% CI = 1.3 to 4.2, P = 0.003) respectively. Two studies also reported a significant proportional reduction in consumption of BZD from baseline to 6 months in intervention groups compared to the control group. The secondary outcome of general health status was measured in two studies; both showed a significant improvement in the intervention group.

Conclusion

A brief intervention in the form of either a letter or a single consultation by GPs, for long-term users of BZD, is an effective and efficient strategy to decrease or stop their medication, without causing adverse consequences.

References: 15 references open in new window

Articles that cite this article?

Keywords: benzodiazepines; cessation of treatment; long term care; patient education as topic; primary care; reduction

Document Type: Research article

DOI: http://dx.doi.org/10.3399/bjgp11X593857

Affiliations: 1: Bond University, Gold Coast, Australia

Publication date: 2011-09-01

More about this publication?

• The British Journal of General Practice (BJGP) is an international journal publishing articles of interest to family practitioners and primary care researchers worldwide. The journal's 2011 Impact Factor is 1.83, making it one of the world's most highly cited journals of general practice and primary health care.
  
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