Identification of barriers and needs in the discontinuation of benzodiazepine receptor agonists in elderly patients of a community in the Alentejo region (Portugal)

Identification of barriers and needs in the discontinuation of benzodiazepine receptor agonists in elderly patients of a community in the Alentejo region (Portugal) – a qualitative study

Tiago De Barros Mendes, Ana Luísa Neves, Paula Broeiro-Gonçalves, Marta Nazha

Keywords: • Benzodiazepines • Deprescription • Geriatrics • Qualitative Research

Background:

The predictors of successful discontinuation of benzodiazapine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and it is appointed the need for further investigation, with more focus from the patients' point of view.
No previous studies were identified that have been carried out in Portugal on this subject.

Research questions:

To identify the barriers and facilitators in the discontinuation of BZRA from the perceptions of elderly patients under prolonged prescription of BZRA, belonging to the same rural community.
To recognize potential intervention targets directed at patients, in order to reduce the prevalence of elderly patients under prolonged prescription of BZRA.

Method:

A set of fifteen semi-structured interviews with patients under prolonged prescription of BZRA was carried.
Content analysis was done by the main researcher and a reviewer in order to identify original emerging themes for the two underlying domains.

Results:

Four themes were identified as barriers to discontinuation of BZRA: (1) patient characteristics, (2) clinical factors, (3) medication-related factors, and (4) context and external factors.
Seven themes were identified as facilitators to discontinuation of BZRA: (1) motivation, (2) patients' knowledge, (3) perception of BZRA insufficiency, (4) access to written information, (5) access to alternatives, (6) time for decision making, and (7) attitudes of health professionals.

Conclusions:

The findings highlight the challenging nature of BZRA discontinuation and the range of barriers and facilitators that impact patients’ behaviour towards this purpose.

Points for discussion:

Elderly patient’s point of view has been seldom studied in the context of discontinuation of benzodiazapine agonist receptors (BZRA)

Understanding patient’s perspectives on the needs and difficulties towards this discontinuation may help for the development of interventions aimed at this purpose

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