Table 2.
Responses to PUBS item: comparison between family physicians and other specialists
| Items | Family physicians (n = 184) | Other specialists (n = 145) | OR for agreement (95% CI) c) | ||
|---|---|---|---|---|---|
| n (%) | Agreement a | Disagreement b | Agreement a | Disagreement b | |
| Doctors’ beliefs about BZD | |||||
| 1. With BZD, the patient gets a high-quality sleep | 44 (23.9%) | 94 (51.1%) | 55 (37.9%) | 57 (39.3%) | 1.94** (1.21–3.13) |
| 2. With BZD, the patient does not wake up so many times during night | 115 (62.5%) | 28 (15.2%) | 93 (64.1%) | 33 (22.8%) | 1.07 (0.68–1.69) |
| 3. With BZD, the patient feels more rested when waking up in the morning | 50 (27.2%) | 73 (39.7%) | 39 (26.9%) | 54 (37.2%) | 0.99 (0.60–1.61) |
| 4. With BZD, the patient feels less angry | 99 (53.8%) | 32 (17.4%) | 96 (66.2%) | 23 (15.9%) | 1.68 * (1.07–2.64) |
| 5. Chronic use of BZD does not represent a health risk to the patient | 7 (3.8%) | 170 (92.4%) | 11 (7.6%) | 119 (82.1%) | 2.08 (0.78–5.49) |
| 6. Chronic use of BZD contributes to the patients’ well-being | 41 (22.3%) | 81 (44%) | 48 (33.1%) | 48 (33.1%) | 1.73* (1.06–2.82) |
| 7. Chronic use of BZD is essential to patients’ anxiety control | 51 (27.7%) | 85 (46.2%) | 48 (33.1%) | 67 (46.2%) | 1.29 (0.80–2.07) |
| 8. Chronic use of BZD is a public health problem | 157 (85.3%) | 12 (6.5%) | 113 (77.9%) | 14 (9.7%) | 1.62 (0.72–3.64) |
| 9. Chronic use of BZD enhances the risk of several falls | 161 (87.5%) | 6 (3.3%) | 98 (67.6%) | 20 (13.8%) | 5.48** (2.13–14.10) |
| 10. Chronic use of BZD may impair cognitive performance | 174 (94.6%) | 4 (2.2%) | 119 (82.1%) | 13 (9%) | 4.75** (1.51–14.92) |
| 11. Chronic use of BZD increases the risk of road traffic accidents | 168 (91.3%) | 5 (2.7%) | 121 (83.4%) | 9 (6.2%) | 2.49* (0.82–7.64) |
| Doctors’ attitudes about BZD prescription | |||||
| 13. BZD consumption in unnecessary in most cases | 121 (65.8%) | 24 (13%) | 83 (57.2%) | 25 (17.2%) | 1.52 (0.81–2.84) |
| 14. It is important to inform the patient about the risk of tolerance associated with BZD | 181 (98.4%) | 1 (0.5%) | 138 (95.2%) | 1 (0.7%) | 1.31 (0.08–21.16) |
| 15. It is important to inform the patient about the risk of addiction associated with BZD | 183 (99.5%) | – | 138 (95.2%) | 4 (2.8%) | 0.10 (0.01–0.89) |
| 16. Chronic use of BZD is justified if the patient feels better and without side effects | 47 (25.5%) | 94 (51.1%) | 71 (49.0%) | 44 (30.3%) | 2.79** (1.76–4.45) |
| 17. I feel pressured by patients to prescribe BZD | 125 (67.9%) | 33 (17.9%) | 44 (30.3%) | 74 (51%) | 6.37** (3.73–10.88) |
| 18. Patients feel like they are not taken seriously when I don’t prescribe BZD | 49 (26.6%) | 83 (45.1%) | 20 (13.8%) | 90 (62.1%) | 2.66** (1.46–4.84) |
| 19. When I refuse to prescribe BZD, I’m challenging the patient-doctor relationship | 37 (20.1%) | 98 (53.3%) | 7 (4.8%) | 109 (75.2%) | 5.88** (2.51–13.79) |
| 22. There is an acceptable level of anxiety and the doctor should help people to deal with it | 173 (94.0%) | 3 (1.6%) | 140 (96.6%) | 2 (1.4%) | 0.82 (0.14–4.99) |
| 23. The easiest way to deal with a patients’ anxiety is to prescribe a BZD | 44 (23.9%) | 123 (66.8%) | 28 (19.3%) | 106 (73.1%) | 0.76 (0.45–1.29) |
| 24. Prescribing BZD in clinical cases of anxiety is the most appropriate way to deal with those cases | 14 (7.6%) | 119 (64.7%) | 16 (11.0%) | 91 (62.8%) | 1.51 (0.71–3.19) |
| 26. Non-pharmacological approaches for anxiety need to be complemented with medication | 39 (21.2%) | 63 (34.2%) | 32 (22.1%) | 52 (35.9%) | 1.05 (0.62–1.79) |
| 27. Non-pharmacological approaches for sleep disorders need to be complemented with medication | 39 (21.2%) | 80 (43.5%) | 39 (26.9%) | 49 (33.8%) | 1.37 (0.82–2.28) |
| 30. Non-pharmacological approaches are appropriate for most patients | 94 (51.1%) | 45 (24.5%) | 59 (40.7%) | 37 (25.5%) | 1.31 (0.76–2.26) |
| Doctors’ self-perception of literacy about BZD | |||||
| 12. I consider myself well informed about the benefits and risks of BZD | 161 (87.5%) | 5 (2.7%) | 94 (64.8%) | 21 (14.5%) | 0.26** (0.15–0.46) |
| 21. I don’t feel capable of helping patients to stop/reduce the BZD consumption | 19 (10.3%) | 136 (73.9%) | 21(14.5%) | 90 (62.1%) | 0.60 (0.31–1.18) |
| 25. My knowledge on non-pharmacological approaches is enough to help patient not to choose for BZD | 68 (37.0%) | 64 (34.8%) | 46 (31.7%) | 61 (42.1%) | 0.79 (0.50–1.27) |
| Doctors’ self-efficacy perception for promoting withdrawal | |||||
| 20. I have difficulties in motivating patients to stop BZDs’ consumption | 114 (62.0%) | 48 (26.1%) | 66 (45.5%) | 40 (27.6%) | 1.44** (0.86–2.42) |
| 28. Psychological treatment of anxiety is of difficult access | 147 (79.9%) | 27 (14.7%) | 104 (71.7%) | 22 (15.2%) | 0.64 (0.38–1.06) |
| 29. It is difficult to motivate patients to see a psychologist | 119 (64.7%) | 38 (20.7%) | 81 (55.9%) | 36 (24.8%) | 0.69 (0.44–1.08) |
* Statistically significant (p-value < .05); ** Highly statistically significant (p-value < .01)
a) Percentage of agreement (answers 4 and 5) b) Percentage of disagreement (answers 1 and 2). c) reference category: family physicians
Neutral point (answer 3 - neither agree or disagree) is not included in the table but was considered for the OR estimation