A meta-synthesis of clinicians’ experiences and perceptions of benzodiazepine prescribing: implications for the integration of health services

Sirdifield, Coral and Anthierens, Sibyl and Creupelandt, Hanne and Chipchase, Susan and Christiaens, Thierry and Siriwardena, A. Niroshan (2013) A meta-synthesis of clinicians’ experiences and perceptions of benzodiazepine prescribing: implications for the integration of health services. In: European Forum for Primary Care: 'Balancing Primary and Secondary Care Provision for More Integration and Better Health Outcomes', 9-10 September 2013, Galatasaray University, Istanbul, Turkey.

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A meta-synthesis of clinicians’ experiences and perceptions of benzodiazepine prescribing: developing an integrated approach for care for insomnia and sleep problems
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Abstract

Purpose: To investigate clinicians’ experiences and perceptions of benzodiazepine prescribing.
Theory: To develop a theory for improving benzodiazepine prescribing practice, exploring implications for an integrated health services approach.
Methods: A multidisciplinary team conducted a systematic review and metasynthesis of qualitative studies published in Western settings between January 1990 and August 2011 using ‘thematic synthesis’. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist.
Findings: We included eight studies. Prescribing was complex and demanding within the constraints of daily practice, leading to variable prescribing by individual practitioners and between GPs. Decisions were influenced by the changing context of GPs’ work, their views of their own role and responsibilities, and their perceptions of benzodiazepines and alternative treatment options. Clinical practice was also influenced by GPs’ perception of patient expectations, the relationship with their patient, and whether they were initiating, continuing or withdrawing benzodiazepines.
Discussion: Benzodiazepine prescribing could be improved in line with current guidance through improved communication with patients, ensuring GPs accept responsibility for deciding whether or not to continue prescribing for patients who were previously managed in secondary care, education and training of primary and secondary care clinicians on other treatments and greater provision of alternatives to drugs.

Keywords:prescribing practices, treatment, systematic review, benzodiazepines, primary health care, inappropriate prescribing, therapeutics, general practice, sleep initiation and maintenance disorders
Subjects:B Subjects allied to Medicine > B230 Pharmacy
A Medicine and Dentistry > A300 Clinical Medicine
Divisions:College of Social Science > School of Health & Social Care
ID Code:12700
Deposited On:15 Dec 2013 20:23

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