Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis

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dc.contributor.authorLynch, Tom
dc.contributor.authorRyan, Cristí­n
dc.contributor.authorHughes, Carmel M.
dc.contributor.authorPresseau, Justin
dc.contributor.authorvan Allen, Zachary M.
dc.contributor.authorBradley, Colin P.
dc.contributor.authorCadogan, Cathal A.
dc.contributor.funderRoyal College of Surgeons in Irelanden
dc.date.accessioned2020-02-06T09:50:21Z
dc.date.available2020-02-06T09:50:21Z
dc.date.issued2020-01-27
dc.date.updated2020-02-06T09:37:29Z
dc.description.abstractAims: To assess the effectiveness of brief interventions in primary care aimed at reducing or discontinuing long‐term benzodiazepine/Z‐drug (BZRA) use. Method: Systematic review of randomised controlled trials of brief interventions in primary care settings aimed at reducing or discontinuing long‐term BZRA use in adults taking BZRAs for ≥3 months. Four electronic databases were searched: PubMed, EMBASE, PsycINFO, CENTRAL. The primary outcome was BZRA use, classified as discontinuation or reduction by ≥25%. The Theoretical Domains Framework (TDF) was used to retrospectively code behavioural determinants targeted by the interventions. The Behaviour Change Technique (BCT) Taxonomy was used to identify interventions’ active components. Study‐specific estimates were pooled, where appropriate, to yield summary risk ratios (RRs) and 95% confidence intervals (CIs). Pearson correlations were used to determine the relationship between intervention effect size and the results of both the TDF and BCT coding. Results: Eight studies were included (n=2071 patients). Compared with usual care, intervention patients were more likely to have discontinued BZRA use at 6 months (8 studies, RR 2.73, 95% CI 1.84‐4.06) and 12 months post‐intervention (2 studies, RR 3.41, 95% CI 2.22‐5.25). TDF domains ‘Knowledge’, ‘Memory, attention and decision processes’, ‘Environmental context and resources’ and ‘Social influences’ were identified as having been included in every intervention. Commonly identified BCTs included ‘Information about health consequences’, ‘Credible source’ and ‘Adding objects to the environment’. There was no detectable relationship between effect size and the results of either the TDF or BCT coding. Conclusion: Brief interventions delivered in primary care are more effective than usual care in reducing and discontinuing long‐term benzodiazepine/Z‐drug use.en
dc.description.sponsorshipRoyal College of Surgeons in Ireland (School of Pharmacy and Biomolecular Sciences - Clement Archer Scholarship)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationLynch, T., Ryan, C., Hughes, C. M., Presseau, J., van Allen, Z. M., Bradley, C. P. and Cadogan, C. A. (2020) 'Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis', Addiction, 115(9), pp. 1618-1639. doi: 10.1111/add.14981en
dc.identifier.doi10.1111/add.14981en
dc.identifier.eissn1360-0443
dc.identifier.endpage1639
dc.identifier.issn0965-2140
dc.identifier.issued9
dc.identifier.journaltitleAddictionen
dc.identifier.startpage1618
dc.identifier.urihttps://hdl.handle.net/10468/9615
dc.identifier.volume115
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.relation.urihttps://onlinelibrary.wiley.com/doi/abs/10.1111/add.14981
dc.rights© 2020 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. Addiction, 115, 1618–1639. REVIEW doi:10.1111/add.14981. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproductionin any medium, provided the original work is properly cited and is not used for commercial purposes.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectBrief interventionen
dc.subjectPrimary careen
dc.subjectLong-term benzodiazepine useen
dc.subjectBZRAen
dc.titleBrief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysisen
dc.typeArticle (peer-reviewed)en
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