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[Long-term effectiveness of an intervention to discontinue chronic benzodiazepine use]
C Vicens Caldentey1, F Fiol Gelabert, E González Garrido
1Centro de Salud Son Serra-La Vileta, Palma de Mallorca. domicatrin@telefónica.net
Introduction:
We establish the long-term effectiveness of a brief intervention to withdraw from chronic benzodiazepine use.
Methods:
Follow-up after a randomized clinical trial.
Setting:
Three health care centers covering 82,000 inhabitants.
Subjects:
135 patients who completed the previous clinical trial (66 from the intervention group, 63 from the control group, 6 had died). Intervention-measurements: the previous clinical trial compared an intervention consisting of standardized advice and a dose tapering schedule against a control group followed by usual care. Results were evaluated at 12 months. main outcome: benzodiazepine use three years after the end of the clinical trial, type of drug and the reason for prescription.
Results:
After 3 years of follow up, 25/66 (37.9%) subjects from the intervention group and 14/63 (22.2%) from the control group were benzodiazepine free. The probability of withdrawal from benzodiazepine between patients in the intervention group was 41% higher than in the control group. Relative risk: 1.41 (95% confidence interval: 0.98-1.66). In the intervention group, 16 from 31 (51.6%) patients who had withdrawn at 12 months were benzodiazepine free after 3 years. The most prescribed benzodiazepine is lorazepam (27.9%), followed by alprazolam (12.4%) and the main reason for prescription is anxiety (16.3%) followed by anxious-depressive disorder (10.9%).
Conclusions:
Even though there is a substantial relapse rate, the intervention to reduce chronic benzodiazepine use remains effective in the long-term.
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