Risk perception, attitudes, and quality of life in a multicomponent benzodiazepine deprescription strategy

Abstract

Background: Multicomponent strategies can reduce benzodiazepine (BZD) use. BenzoStopJuntos (Spanish for “Stop Benzos Together”), a multidisciplinary deprescribing programme of the Andalusian Health Service, supports patients to taper/stop BZD through education, behavioral support, and non-pharmacological alternatives. We evaluated whether early changes (6 months) in risk perception and attitudes—and secondarily, quality of life—were associated with long-term discontinuation of BZD. Methods: In a quasi-experimental pre–post study in two primary care centres (Seville, Spain; n = 243), the intervention included patient education, tapering support, and alternatives for anxiety/insomnia delivered by a multidisciplinary team. Primary outcomes were (a) short-term (6-month) changes in risk perception and attitudes and (b) long-term BZD discontinuation over 5.5 years; the secondary outcome was quality of life (WONCA/ COOP), monitored to detect potential harms. Multivariable logistic regression examined whether 6-month changes in beliefs/attitudes predicted subsequent discontinuation, adjusting for sociodemographic and clinical factors. Results: BZD discontinuation increased from 31.3 % at 6 months to 40.7 % at 5.5 years. Participants who considered BZD safe long-term were more likely to continue use (OR = 2.0; 95 % CI: 1.6–2.6). Fears of worsened anxiety/sleep strongly predicted persistence (OR = 4.7; 95 % CI: 3.6–6.1). Prior intermittent vs continuous use favored discontinuation (OR = 4.9; 95 % CI: 3.7–6.5). Quality of life improved in emotional, social, and physical domains, with no deterioration observed during follow-up. Conclusions: Tailored education and behavioral strategies changed risk perceptions and attitudes, which in turn facilitated sustained BZD discontinuation without adverse effects on quality of life. Addressing patient beliefs and encouraging intermittent use patterns may enhance deprescribing success.