Electronic Intervention for Patient-Managed Benzodiazepine Tapering: A Randomized Clinical Trial.

Area of Science:

• Clinical Medicine
• Digital Health
• Pharmacology

Background:

• Long-term benzodiazepine use affects over 30 million Americans, posing risks like falls, cognitive decline, and dependence.
• A prior trial demonstrated the efficacy of the EMPOWER self-management intervention in reducing benzodiazepine dependence.

Purpose of the Study:

• To replicate the findings of the EMPOWER trial by converting the intervention to an electronic format (EMPOWER-ED).
• To assess the effectiveness of the EMPOWER-ED intervention in reducing long-term benzodiazepine use.

Main Methods:

• A randomized clinical trial involving 161 primary care patients using benzodiazepines long-term.
• Participants were randomized to the electronic EMPOWER-ED intervention or treatment as usual.
• Outcomes included complete benzodiazepine cessation and at least 25% dose reduction at 6-month follow-up, assessed via pharmacy data.

Main Results:

• The EMPOWER-ED group showed a significantly higher likelihood of complete benzodiazepine cessation (OR, 5.31).
• No significant difference was observed in achieving at least a 25% dose reduction between groups.
• Secondary outcomes related to anxiety, sleep, and quality of life did not differ significantly.

Conclusions:

• The electronically delivered EMPOWER-ED intervention effectively promotes benzodiazepine cessation among long-term users.
• This low-cost, self-administered digital tool presents a promising, scalable approach to managing benzodiazepine dependence.
• Widespread adoption by healthcare systems is recommended due to the intervention's public domain status and demonstrated efficacy.