Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials

Article


Gould, R., Coulson, M., Patel, N., Highton-Williamson, E. and Howard, R. 2014. Interventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials. The British Journal of Psychiatry. 204 (2), pp. 98-107. https://doi.org/10.1192/bjp.bp.113.126003
TypeArticle
TitleInterventions for reducing benzodiazepine use in older people: meta-analysis of randomised controlled trials
AuthorsGould, R., Coulson, M., Patel, N., Highton-Williamson, E. and Howard, R.
Abstract

Background
The use of benzodiazepines has been advised against in older people, but prevalence rates remain high.
Aims
To review the evidence for interventions aimed at reducing benzodiazepine use in older people.
Method
We conducted a systematic review, assessment of risk of bias and meta-analyses of randomised controlled trials of benzodiazepine withdrawal and prescribing interventions.
Results
Ten withdrawal and eight prescribing studies met the inclusion criteria. At post-intervention, significantly higher odds of not using benzodiazepines were found with supervised withdrawal with psychotherapy (odds ratio (OR) = 5.06, 95% CI 2.68-9.57, P<0.00001) and withdrawal with prescribing interventions (OR = 1.43, 95% CI 1.02-2.02, P = 0.04) in comparison with the control interventions treatment as usual (TAU), education placebo, withdrawal with or without drug placebo, or psychotherapy alone. Significantly higher odds of not using benzodiazepines were also found for multifaceted prescribing interventions (OR = 1.37, 95% CI 1.10-1.72, P = 0.006) in comparison with control interventions (TAU and prescribing placebo).
Conclusions
Supervised benzodiazepine withdrawal augmented with psychotherapy should be considered in older people, although pragmatic reasons may necessitate consideration of other strategies such as medication review.

Research GroupApplied Health Psychology group
Forensic Psychology Research group
PublisherCambridge University Press
Royal College of Psychiatrists
JournalThe British Journal of Psychiatry
ISSN0007-1250
Electronic1472-1465
Publication dates
Print28 Feb 2014
Online02 Jan 2018
Publication process dates
Deposited26 Feb 2014
Accepted05 Sep 2013
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1192/bjp.bp.113.126003
LanguageEnglish
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