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Discontinuation of chronic benzodiazepine use in primary care: a nonrandomized intervention

2022Artigo científico Acesso restrito
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dc.contributor.authorFernandes, Milene
dc.contributor.authorNeves, Inês
dc.contributor.authorOliveira, Joana
dc.contributor.authorSantos, Osvaldo
dc.contributor.authorAguiar, Pedro
dc.contributor.authorAtalaia, Paula
dc.contributor.authorMatos, Fátima
dc.contributor.authorFreitas, Maria Carina
dc.contributor.authorAlvim, António
dc.contributor.authorMaria, Vasco
dc.date.accessioned2023-09-07T11:02:21Z
dc.date.available2023-09-07T11:02:21Z
dc.date.issued2022
dc.description© The Author(s) 2021. Published by Oxford University Press. All rights reserved.pt_PT
dc.description.abstractBackground: Chronic benzodiazepine use is a challenge in primary care practice. Protocols to support safe discontinuation are still needed, especially in countries with high utilization rates. Objectives: To evaluate the feasibility, effectiveness, and safety of a benzodiazepine discontinuation protocol in primary care setting. Methods: Nonrandomized, single-arm interventional study, at primary care units. Family physicians (FPs) recruited patients (18–85 years-old) with benzodiazepine dependence and chronic daily use ≥3 months. Patients with daily dosages ≥30 mg diazepam-equivalent, taking zolpidem, with a history of other substance abuse or major psychiatric disease were excluded. After the switch to diazepam, the dosage was gradually tapered according to a standardized protocol. Primary endpoint was the percentage of patients who stopped benzodiazepine at the intervention last visit. Dosage reduction, withdrawal symptoms, patients’ and FPs’ satisfaction with the protocol were evaluated. Results: From 66 enrolled patients (74% female; 66.7% aged >64 years; median time of benzodiazepine use was 120 months), 2 withdrew due to medical reasons and 3 presented protocol deviations. Overall, 59.4% of participants successfully stopped benzodiazepine (60.7% when excluding protocol deviations). Men had higher probability of success (relative risk = 0.51, P = 0.001). A total of 31 patients reported at least 1 withdrawal symptom, most frequently insomnia and anxiety. Most of participating FP considered the clinical protocol useful and feasible in daily practice. Among patients completing the protocol, 77% were satisfied. For the patients who reduced dosage, 85% kept without benzodiazepines after 12 months. Conclusion: The discontinuation protocol with standardized dosage reduction was feasible at primary care and showed long-term effectiveness.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFamily Practice, 2022, 241–248pt_PT
dc.identifier.doi10.1093/fampra/cmab143pt_PT
dc.identifier.eissn1460-2229
dc.identifier.issn0263-2136
dc.identifier.urihttp://hdl.handle.net/10451/59161
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation.publisherversionhttps://academic.oup.com/famprapt_PT
dc.subjectBenzodiazepinespt_PT
dc.subjectDeprescribingpt_PT
dc.subjectDiscontinuation protocolpt_PT
dc.subjectPrimary healthcarept_PT
dc.subjectSubstance usept_PT
dc.subjectWithdrawal symptomspt_PT
dc.titleDiscontinuation of chronic benzodiazepine use in primary care: a nonrandomized interventionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage248pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage241pt_PT
oaire.citation.titleFamily Practicept_PT
oaire.citation.volume39pt_PT
person.familyNameFernandes
person.familyNameNeves
person.familyNameOliveira
person.familyNameSantos
person.familyNameMaria
person.givenNameMilene
person.givenNameInês
person.givenNameJoana
person.givenNameOsvaldo
person.givenNameVasco
person.identifier.ciencia-idB411-82DF-2E12
person.identifier.orcid0000-0002-6603-5092
person.identifier.orcid0000-0002-6513-5366
person.identifier.orcid0000-0003-3027-5112
person.identifier.orcid0000-0002-0836-4314
person.identifier.orcid0000-0003-4378-0265
person.identifier.ridF-8895-2016
person.identifier.scopus-author-id57197786253
person.identifier.scopus-author-id7004664870
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication19e0d31e-2a54-4d5d-80b7-4d42ace08111
relation.isAuthorOfPublication4b5c028e-41ab-4fa7-a860-8073777f5b5d
relation.isAuthorOfPublication63995549-79e7-4347-acc7-3c46eee91b64
relation.isAuthorOfPublication6819777d-2080-4708-8f20-0ce67c153687
relation.isAuthorOfPublication559428fd-8556-4a3c-9039-f39c68210715
relation.isAuthorOfPublication.latestForDiscovery6819777d-2080-4708-8f20-0ce67c153687

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