Analysis of benzodiazepine withdrawal program managed by primary care nurses in Spain

被引:21
作者
Lopez-Peig C. [1 ,6 ]
Mundet X. [2 ,3 ]
Casabella B. [1 ]
Del Val J.L. [2 ]
Lacasta D. [4 ]
Diogene E. [3 ,5 ]
机构
[1] Primary Care Center Raval, Sud. Institut Català de la Salut, 08001, Barcelona
[2] Unitat de Suport de la Recerca Barcelona Ciutat - IDIAP Jordi Gol, RedIAPP Institut Català de la Salut, 08025, Barcelona
[3] Universitat Autònoma de Barcelona, 08193, Bellaterra
[4] Primary Care Center la Salut, Institut Català de la Salut, 08914, Badalona
[5] Institut Català de Farmacologia, Barcelona
[6] Woodberry Practice, Enfield. NHS Trust, London, Winchmore Hill
关键词
Benzodiazepine; Habituation drug therapy; Primary care;
D O I
10.1186/1756-0500-5-684
中图分类号
学科分类号
摘要
Background: Benzodiazepine (BZD), the long-term treatment of which is harmful for cognitive function, is widely prescribed by General Practitioners in Spain. Based on studies performed in other countries we designed a nurse-led BZD withdrawal program adapted to Spanish Primary Care working conditions. Results: A pseudo-experimental (before-after) study took place in two Primary Care Centres in Barcelona. From a sample of 1150 patients, 79 were identified. They were over 44 years old and had been daily users of BZD for a period exceeding six months. Out of the target group 51 patients agreed to participate. BZD dosage was reduced every 2-4 weeks by 25% of the initial dose with the optional support of Hydroxyzine or Valerian. The rating measurements were: reduction of BZD prescription, demographic variables, the Short-Form Health Survey (SF-12) to measure quality of life, the Medical Outcomes Study (MOS) Sleep Scale, and the Goldberg Depression and Anxiety Scale. By the end of the six-month intervention, 80.4% of the patients had discontinued BZD and 64% maintained abstinence at one year. An improvement in all parameters of the Goldberg scale (p <0.05) and in the mental component of SF-12 at 3.3 points (p = 0.024), as well as in most components of the MOS scale, was observed in the group that had discontinued BZD. No significant differences in these scales before and after the intervention were observed in the group that had not discontinued. Conclusions: At one year approximately 2/3 of the patients had ceased taking BZD. They showed an overall improvement in depression and anxiety scales, and in the mental component of the quality of life scale. There was no apparent reduction in the sleep quality indicators in most of the analysed components. Nurses in a Primary Care setting can successfully implement a BZD withdrawal program. © 2012 Lopez-Peig et al; licensee BioMed Central Ltd.
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