Summary of findings for the main comparison. CBT (plus taper) versus taper for BZD harmful use, abuse or dependence.
| CBT (plus taper) versus taper for BZD harmful use, abuse or dependence | |||||
| Patient or population: patients with BZD harmful use, abuse or dependence Settings: outpatient Intervention: CBT (plus taper) versus taper | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Control | CBT (plus Taper) versus Taper | ||||
| Successful discontinuation of BZDs‐ post treatment Objective and subjective Follow‐up: mean 10.5 weeks | Study population | RR 1.4 (1.05 to 1.86) | 423 (9 studies) | ⊕⊕⊕⊝ moderate1 | |
| 443 per 1000 | 621 per 1000 (466 to 825) | ||||
| Moderate | |||||
| 400 per 1000 | 560 per 1000 (420 to 744) | ||||
| Successful discontinuation of BZDs‐ 12 month follow‐up Objective and subjective Follow‐up: mean 12 months | Study population | RR 1.42 (0.89 to 2.28) | 284 (5 studies) | ⊕⊕⊕⊝ moderate2 | |
| 336 per 1000 | 477 per 1000 (299 to 766) | ||||
| Moderate | |||||
| 300 per 1000 | 426 per 1000 (267 to 684) | ||||
| Reduce BZDs> 50% ‐ post treatment Objective Follow‐up: mean 8 weeks | Study population | OR 0.93 (0.11 to 8.18) | 178 (3 studies) | ⊕⊕⊝⊝ low2,3 | |
| 750 per 1000 | 736 per 1000 (248 to 961) | ||||
| Moderate | |||||
| 690 per 1000 | 674 per 1000 (197 to 948) | ||||
| Reduce BZDs> 50% ‐ 12 month follow‐up Objective Follow‐up: mean 12 months | Study population | OR 1.07 (0.14 to 8.21) | 125 (2 studies) | ⊕⊕⊝⊝ low3,4 | |
| 610 per 1000 | 626 per 1000 (180 to 928) | ||||
| Moderate | |||||
| 609 per 1000 | 625 per 1000 (179 to 927) | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio; OR: odds ratio; BZD: benzodiazepine; CBT: cognitive behavioural therapy. | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1Downgraded by one level due to serious risk of bias. Five studies were at high risk of detection bias; one study was also at high risk of attrition bias and another one at high risk of detection bias. 2Downgraded by one level due to serious risk of bias. Two studies were at high risk of detection bias and one study each was also at high risk of attrition and selection bias. 3Downgraded by one level due to serious imprecision (wide CIs). 4Downgraded by one level due to serious risk of bias. One study was at high risk of detection and attrition bias.