Piloting implementation strategies to support deprescribing benzodiazepines in primary care practitioners

Co-design process A deprescribing conversation tool was co-designed by consumers with lived experience, general practitioners (GPs), and a GP advisory group. Consumers contributed via 60-minute focus groups, leading to a draft tool that was refined through an advisory group meeting and individual GP interviews (n = 13). The resulting toolkit—also co-designed with GPs—includes the conversation tool, a tapering protocol, decision aid, patient resources, and access to free counselling and deprescribing support services (available in both digital and print formats). For the toolkit co-design, GPs participated in a Delphi study to identify the most useful support strategies, which were further refined through a one-hour advisory group meeting and 45-minute individual interviews with GPs (n = 7). Toolkit components – brief descriptions Conversation tool – 1 page co-designed document guiding GP through stages of readiness, main practice points and key questions. The flipside of this resource contains information on why deprescribing is important (statistics on side effects), preparation information, reduction rates and the monitoring process. Tapering protocol and decision aid – based on the Maudsley deprescribing guidelines (Horowitz M, Taylor DM. The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs. New York: Wiley-Blackwell; 2024.) Patient resources – existing patient resources on the topic (Deprescribing.org & National Institute for Health and Care Excellence resources). List of available (free) counselling / deprescribing support – This is a list of freely available support services by state collated by the research team. Toolkit implementation GPs will be given access to the conversation tool resource via email & hard copies. These will contain a QR code that will link to a hosted website containing the remaining resources (tapering protocol & decision aid, patient resources, access to free counselling and deprescribing support services). In addition, GPs will have access to a 1-hour workshop, co-delivered by a psychologist/Benzodiazepine deprescribing counsellor from an Alcohol and other drug (AOD) treatment service in Victoria (Reconnexion) and general practitioner. The workshop will involve practical deprescribing strategies. Participating GPs will be eligible for Continuing Professional Development (CPD) points for workshop attendance and monitoring. The implementation pilot will have a 6-month duration, with toolkit resources delivered throughout, and the workshop at one time point. Depending on need there might be multiple workshops, but each GP will have access to 1 live workshop. Adherence to the strategies will be assessed through survey and interview responses at 3 months and 6 months.

Co-design process A deprescribing conversation tool was co-designed by individuals with lived / living experience (LLE), general practitioners (GPs), and a GP advisory group. LLE contributed via 60-minute focus groups, leading to a draft tool that was refined through an advisory group meeting and individual GP interviews (n = 13). The resulting toolkit—also co-designed with GPs—includes the conversation tool, a tapering protocol, decision aid, patient resources, and access to free counselling and deprescribing support services (available in both digital and print formats). For the toolkit co-design, GPs participated in a Delphi study to identify the most useful support strategies, which were further refined through a one-hour advisory group meeting and 45-minute individual interviews with GPs (n = 7). Toolkit components – brief descriptions Conversation tool – 1 page co-designed document guiding GP through stages of readiness, main practice points and key questions. The flipside of this resource contains information on why deprescribing is important (statistics on side effects), preparation information, reduction rates and the monitoring process. Tapering protocol and decision aid – based on the Maudsley deprescribing guidelines (Horowitz M, Taylor DM. The Maudsley Deprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs. New York: Wiley-Blackwell; 2024.) Patient resources – existing patient resources on the topic (Deprescribing.org & National Institute for Health and Care Excellence resources). List of available (free) counselling / deprescribing support – This is a list of freely available support services by state collated by the research team. A taper diary Toolkit implementation GPs will be given access to the conversation tool resource via email & hard copies. These will contain a QR code that will link to a hosted website containing the remaining resources (tapering protocol & decision aid, patient resources, access to free counselling and deprescribing support services). In addition, GPs will have access to a 1-hour workshop, co-delivered by a psychologist/Benzodiazepine deprescribing counsellor from an Alcohol and other drug (AOD) treatment service in Victoria (Reconnexion) and general practitioner. The workshop will involve practical deprescribing strategies. Participating GPs will be eligible for Continuing Professional Development (CPD) points for workshop attendance and monitoring. The implementation pilot will have a 6-month duration, with toolkit resources delivered throughout, and the workshop at one time point. Depending on need there might be multiple workshops, but each GP will have access to 1 live workshop. Adherence to the strategies will be assessed through survey and interview responses at 3 months and 6 months.