Interesting post in February’s BJGP – a three-arm RCT looked at how to persuade patients on long-term BZDs to stop. The group looked at were adults (18 – 80 yrs) who had used BZDs daily for at least six months and who did not have terminal illness, severe physical illness, severe anxiety or depression, psychosis, personality disorder, alcohol or illicit drug abuse, expected harm from stopping BZDs, or current treatment from a psychiatrist. Which would eliminate probably almost everybody.
Anyway, what the trial found was that:
- Structured intervention – visit (I’m not sure whether this meant actually visiting or an appointment), educational interview about beneficial/adverse effects of long-term use, written educational support, and instructions on tailored stepped-dose reduction – worked better than usual care for persuading people to stop. An extra 30% (attributable benefit) of people in this group had stopped at 3 year follow-up, compared to the ‘usual care’ control group.
- However, adding in regular follow-up visits every 2 – 3 weeks did not make very much difference over and above the above structured intervention.
(BJGP 2016; 66:75 – 6)