Minimal Interventions to Decrease Long-Term Use of Benzodiazepines in Primary Care: A Systematic Review and Meta-Analysis
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BACKGROUND: Long-term use of benzodiazepines (BZDs) is common. Not only is such use ineffective, but it also has several risks in addition to dependence, and remains a significant problem among the older population. AIM: To systematically review randomised controlled trials that evaluate the effectiveness of minimal interventions to reduce the long-term use of BZDs in primary care. DESIGN AND SETTING: Systematic review and meta-analysis of randomised controlled trials in UK general practices. METHOD: Cochrane Central, MEDLINE, and Embase (1967-2010) were searched for trials of minimal interventions (such as a single letter or one consultation from a GP) for patients in primary care with long-term (>3 months) BZD use. Pooled risk differences were calculated with 95% confidence intervals. RESULTS: From 646 potentially relevant abstracts, three studies (615 patients) met all the inclusion criteria. The pooled risk ratio showed a significant reduction/cessation in BZD consumption in the minimal intervention groups compared to usual care (risk ratio [RR] = 2.04, 95% confidence interval [CI] = 1.5 to 2.8, [corrected] P<0.001; RR = 2.4, 95% CI = 1.3 to 4.3, P = 0.008) respectively. Two studies also reported a significant proportional reduction in consumption of BZD from baseline to 6 months in intervention groups compared to the control group. The secondary outcome of general health status was measured in two studies; both showed a significant improvement in the intervention group. CONCLUSION: A brief intervention in the form of either a letter or a single consultation by GPs, for long-term users of BZD, is an effective and efficient strategy to decrease or stop their medication, without causing adverse consequences.
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Acknowledging problematic use demands an understanding of the impact of the medication over time, skills that should be developed by other interventions such as psychoeducation or motivational interviewing.
“Acknowledging problematic use demands an understanding of the impact of the medication over time, skills that should be developed by other interventions, such as psychoeducation or motivational interviewing, as observed in previous studies with this population [11, 47, 48].”
From Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study (2018) · cites this paper as [47]
The Additional information section advises explaining concerns about long-term use and highlighting side effects, which supports the importance of understanding the medication’s impact over time. The paper does not say that acknowledging problematic use requires that understanding, or that psychoeducation or motivational interviewing develops the relevant skills; it focuses on brief letters and advice. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSeveral publications argue that brief interventions for benzodiazepine discontinuation are very effective, doubling or tripling the abstinence rate achieved in standard care.
“Several publications [24,79,80,81,82,83] argue that these brief interventions are very effective, doubling or tripling the abstinence rate achieved in standard care.”
From Cognitive behavioral therapy and acceptance and commitment therapy for the discontinuation of long-term benzodiazepine use in insomnia and anxiety disorders (2021) · cites this paper as [83]
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Tiltak mot misbruk av vanedannende midler
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- Authors
- Mugunthan, K., McGuire, T., & Glasziou, P.
- Affiliations
- Bond University (AU)
- Venue
- British Journal of General Practice
- Published
- 2011-09
- Volume
- 61
- Issue
- 590
- Pages
- e573-e578
- ISSN
- 0960-1643 (ISSN-L)
- 1478-5242
- PMC
- PMC3162180
- OpenAlex
- W2153607529
- Cited by
- 123
- References
- 20
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 7 · 2023: 2 · 2022: 6 · 2021: 15 · 2020: 11 · 2019: 9 · 2018: 19 · 2017: 8 · 2016: 11 · 2015: 12 · 2014: 10 · 2013: 4 · 2012: 1
- FWCI
- 0.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of General Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Bond University Research Portal (Bond University) (submittedVersion, other-oa)
- e-publications@bond (Bond University) (submittedVersion)
- Funders
- Bond University
- National Health and Medical Research Council (527500)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- benzodiazepines, long-term benzodiazepine use, brief intervention, primary care, general practice, patient letters, health status, older adults, benzodiazepine dependence
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Benzodiazepines, Communication, Female, United Kingdom, Humans, Long-Term Care, Male, Middle Aged, Patient Education as Topic, Physician-Patient Relations, Referral and Consultation, Risk Factors, Randomized Controlled Trials as Topic, Young Adult, General Practice
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