Older adults’ perceptions of deprescribing chronic benzodiazepines

• Main Authors: Choi, J. (Author), Vordenberg, S.E (Author)
• Format: Article
• Language: English
• Published: Elsevier B.V. 2021
• Subjects: abnormal sensation; adverse drug reaction; aged; Aged; alprazolam; anxiety disorder; Article; attitude to health; benzodiazepine; benzodiazepine derivative; Benzodiazepines; bipolar disorder; chronic pain; clinical article; clonazepam; comorbidity; concentration loss; constipation; deprescription; Deprescriptions; depression; drug efficacy; drug safety; drug withdrawal; Drug-Related Side Effects and Adverse Reactions; female; Female; health care system; Health Knowledge, Attitudes, Practice; human; Humans; insomnia; lorazepam; low drug dose; male; malignant neoplasm; middle aged; Middle Aged; nocturia; perception; Perception; posttraumatic stress disorder; prescribing practice; relapse; rheumatoid arthritis; semi structured interview; sleep disorder; temazepam; withdrawal syndrome
• Online Access: View Fulltext in Publisher

 Objective: The primary objective of our study was to explore older adults’ willingness to stop or lower the dose or frequency their chronic benzodiazepine with the long-term goal of developing a patient-centered intervention to support older adults during the deprescribing process. Methods: We conducted semistructured interviews with adults aged 60 years and older who reported taking a benzodiazepine for at least 3 months. We recruited participants using our institutional research recruitment website between September and November 2019. Eligible participants completed an interview which was audio-recorded and subsequently transcribed. We identified themes related to older adults’ willingness to consider deprescribing their benzodiazepine, if recommended by their prescriber in a hypothetical scenario. Secondary outcomes focused on their use and perceptions of taking a benzodiazepine as well as their experiences attempting to stop the medication. Results: Among the 21 participants, most were female (n = 14, 66.7%), white (n = 20, 95.2%), and reported good or fair health (n = 17, 81.0%). More than three-fourths of participants who reported data (n = 14 of 18, 77.8%) had taken a benzodiazepine for 6 or more years. Participants generally reported that the medication was very effective (n = 16, 76.2%) and adverse effects were infrequent (n = 5, 23.8%). Participants varied widely in their attitudes toward the hypothetical questions about changing their current benzodiazepine. A total of 7 people were open to stopping the medication, 4 were willing to potentially consider it, and 10 were resistant. However, most of the participants were open to the idea of de-escalation (n = 17, 81.0%). Conclusion: Many older adults were willing to consider deprescribing a long-term benzodiazepine if it were recommended by their prescriber. Older adults were more open to consider lowering the dose or frequency of the chronic benzodiazepine than stopping the medication. Further research is needed to design a patient-centered intervention tool to support prescribers and older adults in deprescribing conversations about benzodiazepines. © 2021 American Pharmacists Association®