Neuropsychiatric Disease and Treatment (Jun 2021)

Different Attitudes of Patients and Psychiatrists Toward Benzodiazepine Treatment

  • Kawamata Y,
  • Sugawara N,
  • Ishioka M,
  • Kubo K,
  • Suzuki K,
  • Fujii A,
  • Furukori H,
  • Nakagami T,
  • Yasui-Furukori N,
  • Shimoda K

Journal volume & issue
Vol. Volume 17
pp. 1927 – 1936

Abstract

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Yasushi Kawamata,1 Norio Sugawara,1,2 Masamichi Ishioka,3 Kazutoshi Kubo,4 Katsuji Suzuki,5 Akira Fujii,6 Hanako Furukori,7 Taku Nakagami,8 Norio Yasui-Furukori,1,2 Kazutaka Shimoda1 1Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan; 2Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; 3Department of Psychiatry, Minato Hospital, Hachinohe, Japan; 4Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan; 5Department of Psychiatry, Aomori Central Hospital, Aomori, Japan; 6Department of Neuropsychiatry, Mutsu General Hospital, Mutsu, Japan; 7Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan; 8Department of Psychiatry, Nakagami Mental Clinic, Ohdate, JapanCorrespondence: Norio Yasui-FurukoriDepartment of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, JapanTel +81-28-287-2153Fax +81-28-286-5187Email [email protected]: Concern regarding the benefit/risk ratio of the long-term use of benzodiazepines (BDZs) and Z-drugs is increasing. To prevent the risk of dependence in BDZ long-term use, it is essential to understand the attitudes of patients and psychiatrists toward BDZ treatment. The aims of this investigation were to 1) obtain information on patients’ attitudes with long-term BDZ use and their referring psychiatrists’ attitudes toward BDZ treatment, including their perception of the difficulty of reducing the dose of BDZs, and 2) identify discrepancies between patients’ and psychiatrists’ perceptions.Methods: A brief questionnaire was constructed to investigate the attitudes of patients receiving BDZ treatment and their referring psychiatrists. Our sample comprised 155 patients who received BDZ treatment for more than one year and their referring eight psychiatrists. Both the patients and their psychiatrists completed our questionnaire between August 2017 and December 2017.Results: Of the patients, 13% felt that it was more difficult to reduce the dose of BDZs than their referring psychiatrists (type A discrepancy), while 25% felt that it was less difficult (type B discrepancy). In the multivariate logistic regression analysis, the female sex and both the patients’ (“psychotherapy plus BDZs was necessary” and “it was necessary to increase the dose of BDZs”) and psychiatrists’ beliefs (“short-term prescription was justified”) were associated with type A discrepancies. Type B discrepancies were associated with psychiatrists’ beliefs that the patient’s wishes justified the use of BDZs and that the cessation of treatment with BDZs would lead to the deterioration of their rapport with their patients.Conclusion: To overcome the discrepancies in the attitudes of patients and psychiatrists toward the cessation of BDZ treatment, it is necessary to promote patient-centered care involving patient psychoeducation and practice guidelines for the decision-making process. Further studies investigating the promotion of patient-centered care to reduce BDZ use are needed.Keywords: dependence, benzodiazepine receptor agonist, anxiolytics, hypnotics, belief

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