Role of the prescriber in supporting patients to discontinue benzodiazepines: a qualitative study

BACKGROUND: Given the prevalence of long-term benzodiazepine (BZD) prescribing, increased monitoring through the implementation of prescription monitoring programmes (PMPs) may be the necessary impetus to promote BZD deprescribing. Despite evidence promoting the importance of patient-centred care, GPs have not been sufficiently supported to implement these principles through current deprescribing practice. AIM: To investigate patients’ perception of their prescriber’s influence on ceasing BZD use, including their willingness to take their advice, and to understand how a patient’s stage of change influences the barriers and facilitators they perceive to discontinuing BZDs. DESIGN AND SETTING: An online survey and qualitative interviews with 22 long-term users of BZD (≥6 months), aged 18–69 years, recruited from the general population in Victoria, Australia. METHOD: Two groups of users of BZD participated, one in the process of reducing their BZD and one not reducing, and were categorised according to their stage of change. Data underwent thematic analysis to identify barriers and facilitators to reducing BZDs both at the patient level and the prescriber level. RESULTS: BZD patients’ perceptions of the prescriber influence were characterised by prescribing behaviours, treatment approach, and attitude. Barriers and facilitators to reducing their BZD were mapped against their stage of change. Irrespective of their stage of change, participants reported they would be willing to try reducing their BZD if they trusted their prescriber. CONCLUSION: This study illustrates that, with a few key strategies at each step of the deprescribing conversation, GPs are well positioned to tackle the issue of long-term BZD use in a manner that is patient centred.