Benzodiazepine (BZD) and Related Drugs, Deprescription
Conditions
Keywords
Benzodiazepine (BZD) and related drugs, Deprescribing, Safety, Older patients
Brief summary
Benzodiazepine (BZD) and related drugs are sedative anxiolytics and hypnotics that should be avoided especially in people aged 65 years and older, given the high risk of falling, fracture, dependence, respiratory depression and cognitive disorders. Despite these contraindications, their consumption continues to increase in Switzerland. Although it can be assumed that deprescribing a drug has a direct benefit, it is nevertheless necessary to determine how to implement this process effectively and safely. To change healthcare professionals' prescribing behaviours for BZD, the most common deprescribing interventions include identification of appropriate patients, education and training of GPs and patients, and gradual and appropriate reduction of the dose of BZD. Thus, the DELTA CARE NETWORK and the DELTA VAUD CARE NETWORK have set themselves the task of evaluating the effectiveness of a multimodal deprescribing intervention for Delta primary care physicians and their patients aged 65 and over, in the cantons of Geneva and Vaud. The goal is to reduce the total BZD prescription rate among this population. This quality development project is fully in line with the Quality Federal Commission's objectives of efficiency, safety, patient-centred and in the interests of the patient.
Interventions
OTHERThematic quality circles - Deprescription
Thematic quality circles on benzodiazepines and analogues with a pharmacist (practical cases)
Sponsors
Réseau de soins Delta
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Intervention model description
Cluster randomised controlled trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Physician who attended a quality cercle in the cantons of Geneva and Vaud * Prescribed at least one prescription of Benzodiazepines during the year of analysis to patient aged 65 years and older
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate Benzodiazepine (BZD) and related drugs prescribed by primary care physicians | 9 months | Reduce the total BZD prescribing frequency by 20% 9 months after the interventioncompared to the control group (DDD/1000 patients over 9 months). The drug measure will be the DDD daily dose defined by the World Health Organization Collaborating Centre for Drug Statistics Methodology (or number of tablets or number of packages). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of patients aged 65 years who took long-term BZD | 18 months | Reduce by 20% the prevalence of 65-year-old patients with long-term use (more than 3 months) of BZD as well as the prevalence of long-term users 18 months after intervention (number of BDZ patients per physician/QC per year). |
Countries
Switzerland
Outcome results
None listed