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. 2013 Apr 5;30(5):297–303. [Article in Spanish] doi: 10.1016/S0212-6567(02)79031-8

Factores que influyen en la prescripción de benzodiacepinas y acciones para mejorar su uso: un estudio Delphi en médicos de atención primaria☆

Factors that affect the prescription of benzodiazepines and actions to improve their use: a delphi study of primary care doctors

T Fernández Álvarez a,*, MJ Gómez Castro b, C Baides Morente c, J Martínez Fernández c
PMCID: PMC7684192  PMID: 12372211

Abstract

Objectives

To identify the factors that affect the prescription of benzodiazepines and similar drugs and the actions that can be taken to reduce their prescription.

Design

Consensus method. Delphi technique.

Setting

Four primary care areas in Asturias.

Participants

39 doctors from primary care teams agreed voluntarily to take part in the study, and 32 completed the study. They belonged to 20 health centres.

Method

They were sent by mail three questionnaires one after the other. The second and third questionnaires were worked out on the basis of the analysis of the information from the replies to the preceding questionnaire. Those who did not send in a reply were reminded by phone.

Results

The 5 most influential factors in benzodiazepine prescription were agreed: reduction in the threshold of tolerance of emotional discomfort; increase of the prevalence of pathologies; lack of time in the consulting-room; social and economic conditioning factors; properties of the benzodiazepine family. The 5 most important actions that could reduce prescription of these drugs were agreed: general health education; reduction in case loads; making doctors more conscious of prescribing correctly; strengthening the social support network; doctors fomenting use of effective alternative treatments.

Conclusions

The prescription of benzodiazepines and their analogues is a multi-factorial action with social and psychological roots. The action most voted on to reduce their prescription was general health education.

Key-words: Benzodiazepine prescription, Factors, Intervention

Footnotes

☆

Centro de Salud de La Magdalena-Carriona. Área III del INSALUD. Avilés (Asturias).

Bibliografía

  • 1.Escrivá Ferrairó R., Pérez Díez A., Lumbreras García C., Molina París J., Sanz Cuesta T., Corral Sánchez M.A. Prescripción de benzodiacepinas en un centro de salud: prevalencia, cómo es suconsumo y características del consumidor. Aten Primaria. 2000;25:107–110. doi: 10.1016/S0212-6567(00)78472-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Mateo Fernández R., Rupérez Cordero O., Hernando Blázquez M.A., Delgado Nicolás M.A., Sánchez González R. Consumo de psicofámarcos en atención primaria. Aten Primaria. 1997;19:47–50. [PubMed] [Google Scholar]
  • 3.Indicadores de la prestación farmacéutica en el Instituto Nacio- nal de la Salud . Vol. II; n.° 2. Anual 2000. INSALUD. Subdirección General de Coordinación Administrativa; Madrid: 2001. [Google Scholar]
  • 4.De la Gándara Martín J.J. Manejo de la depresión y ansiedad en atención primaria. Aten Primaria. 1997;20:389–394. [PubMed] [Google Scholar]
  • 5.Abádanes Herranz J.C., Cabedo García V., Cunillera Granó R., García Díez J.J., Jolín Garijo L., Martín Bun M. Factores que influyen en la prescripción farmacológica del médico de atención primaria. Aten Primaria. 1998;22:391–398. [PubMed] [Google Scholar]
  • 6.Larizgoitia Jáuregui I., Rodríguez Bermúdez J.R., Ganados Nava- rrete A. Determinantes en la toma de decisiones clínicas en atención primaria: opinión de los profesionales. Aten Primaria. 1998;22:505–513. [PubMed] [Google Scholar]
  • 7.Caamaño F., Figueiras A., Gestal-Otero J.J. Condicionantes de la prescripción en atención primaria. Aten Primaria. 2001;27:43–48. doi: 10.1016/S0212-6567(01)78772-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Mant A., Mattick R.P., De Burgh S., Donnelly N., Hall W. Ben- zodiazepine prescribing in general practice: dispelling some myths. Fam Pract. 1995;12:37–43. doi: 10.1093/fampra/12.1.37. [DOI] [PubMed] [Google Scholar]
  • 9.Butler C.C., Rollnick S., Pill R., Maggs-Rapport F., Stott N. Un derstanding the culture of prescribing: qualitative study of gene ral practitioners’ and patients’ perceptions of antibiotics for sore throats. BMJ. 1998;317:637–642. doi: 10.1136/bmj.317.7159.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Tomlin Z., Humphrey C., Rogers S. General pracitoners’ percep tions of effective health care. BMJ. 1999;318:1532–1535. doi: 10.1136/bmj.318.7197.1532. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Cormack M.A., Howells E. Factors linked to the prescribing of benzodiazepines by general practice principals and trainers. Fam Pract. 1992;9:466–471. doi: 10.1093/fampra/9.4.466. [DOI] [PubMed] [Google Scholar]
  • 12.Peiró Moreno S., Porbetella Argelaguet E. No todo es acuerdo en el consenso: limitaciones de los métodos de consenso en los ser- vicios de salud. Gac Sanit. 1993;7:294–300. doi: 10.1016/s0213-9111(93)71165-6. [DOI] [PubMed] [Google Scholar]
  • 13.Campbell S.M., Hann M., Roland M.O., Quayle J.A., Shekelle P.G. The effect of panel membership and feedback on ratings in a two-round Delphi survey. Med Care. 1999;37:964–968. doi: 10.1097/00005650-199909000-00012. [DOI] [PubMed] [Google Scholar]
  • 14.Hamilton I.J.D., Ready L.M., Sullivan F.M. A survey of general practitioners attitudes to benzodiazepine overprescribing. He alth Bull. 1990;48:299–303. [PubMed] [Google Scholar]
  • 15.Bendtsen P., Hensing G., McKenzie L., Stridsman A.K. Prescri bing benzodiazepines, a critical incident study of a physician di lemma. Soc Sci Med. 1999;49:459–467. doi: 10.1016/s0277-9536(99)00133-1. [DOI] [PubMed] [Google Scholar]
  • 16.Boixet M., Batlle E., Bolibar I. Benzodiazepines in primary he alth care: a survey of general practitioners prescribing patterns. Addiction. 1996;91:549–556. doi: 10.1046/j.1360-0443.1996.9145499.x. [DOI] [PubMed] [Google Scholar]
  • 17.Pérez Urdániz A., Santos García J.M., Molina Ramos R., Rubio Larrosa V., Carrasco Pereira J.L., MosqueiraTerrónI Aspectos socioculturales en la génesis de los trastornos de la persona- lidad. Actas Esp Psiquiatr. 2001;29:47–57. [PubMed] [Google Scholar]
  • 18.Zwar N.A., Wolk J., Gordon J.J., Sanson-Ficher R.W. Benzodia- zepne prescribing by GP registars. A trial of educational outre ach. Aust Fam Physician. 2000;29:1104–1107. [PubMed] [Google Scholar]
  • 19.Berings D., Blondeel L., Habraken H. The effect of industry-in dependent drug information on the prescribing of benzodiazep- nes in general practice. Eur J Clin Pharmacol. 1994;46:501–505. doi: 10.1007/BF00196105. [DOI] [PubMed] [Google Scholar]
  • 20.Burg S., Mant A., Mattick R., Donnelly N., Hall W., Bridges- Webb C. A controlled trial of educational visiting to improve benzodiazepine pescribing in general practice. Aust J Pub He alth. 1995;19:142–148. doi: 10.1111/j.1753-6405.1995.tb00364.x. [DOI] [PubMed] [Google Scholar]

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