J Am Pharm Assoc (2003). 2021 Sep-Oct;61(5):533-538.e3. doi: 10.1016/j.japh.2021.04.003. Epub 2021 Apr 20.
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.
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.
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%).
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.
我们研究的主要目的是探讨老年人停止或降低长期服用的慢性苯二氮䓬类药物剂量或频率的意愿，以期制定以患者为中心的干预措施，在减药过程中为老年人提供支持。
我们对年龄在 60 岁及以上、至少服用苯二氮䓬类药物 3 个月的成年人进行了半结构式访谈。我们于 2019 年 9 月至 11 月通过我们的机构研究招募网站招募参与者。符合条件的参与者完成了一次访谈，访谈内容被录音并随后转录。我们确定了与老年人在假设情况下考虑停止或减少其苯二氮䓬类药物的意愿相关的主题。次要结果集中在他们使用和对服用苯二氮䓬类药物的看法，以及他们尝试停止用药的经历。
在 21 名参与者中，大多数为女性（n=14，66.7%）、白人（n=20，95.2%），自述健康状况良好或一般（n=17，81.0%）。超过四分之三报告数据的参与者（n=14 名，77.8%）已经服用苯二氮䓬类药物 6 年或以上。参与者普遍报告称，该药物非常有效（n=16，76.2%），且不良反应罕见（n=5，23.8%）。对于改变当前苯二氮䓬类药物的假设问题，参与者的态度差异很大。共有 7 人愿意停药，4 人愿意考虑，10 人拒绝。然而，大多数参与者对逐渐减少剂量的想法持开放态度（n=17，81.0%）。
许多老年人愿意考虑在其医生建议下停止长期服用苯二氮䓬类药物。与停止药物治疗相比，老年人更愿意考虑降低慢性苯二氮䓬类药物的剂量或频率。需要进一步研究以设计以患者为中心的干预工具，以支持医生和老年人开展有关苯二氮䓬类药物的减药对话。
