A Durable Minimal Intervention Strategy to Reduce Benzodiazepine Use in a Primary Care Population

Area of Science:

• Pharmacology and General Practice Research
• Addiction Medicine and Public Health

Background:

• Benzodiazepines, including diazepam, are widely prescribed, with significant long-term use and addiction potential.
• Many patients continue long-term benzodiazepine prescriptions despite potential adverse effects.
• The need for effective strategies to reduce long-term diazepam prescribing in primary care is critical.

Purpose of the Study:

• To evaluate a minimal intervention strategy for reducing and stopping repeat diazepam prescriptions.
• To assess the sustainability of prescription changes at 24 months.
• To investigate the impact of prescription reviews on long-term diazepam use in general practice.

Main Methods:

• A minimal intervention strategy was implemented in a semi-rural general practice.
• Patients on repeat diazepam prescriptions received a general practitioner review.
• Individualized dose reduction grids facilitated gradual diazepam titration; interrupted time series analysis was used for evaluation at 12 and 24 months.

Main Results:

• Out of 92 patients with repeat diazepam prescriptions, 87 (94.6%) attended a review.
• At 24 months, 81.8% of patients (63/77) had stopped or were stopping regular diazepam use.
• A statistically significant reduction in monthly diazepam prescription was observed (2.2 to 0.7 DDD/1,000 patients/day).

Conclusions:

• A collaborative minimal intervention strategy between primary and secondary care effectively reduced diazepam prescribing.
• The observed reduction in diazepam prescriptions was durable and sustained at 24 months.
• This approach offers a viable model for managing long-term benzodiazepine use in general practice settings.