A tailored e-learning gives long-term changes in determinants of GPs' benzodiazepines prescribing: a pretest-posttest study with self-report assessments

Hanne Creupelandt; Sibyl Anthierens; Hilde Habraken; Coral Sirdifield; Aloysius Niroshan Siriwardena; Thierry Christiaens

doi:10.1080/02813432.2019.1663591

A tailored e-learning gives long-term changes in determinants of GPs' benzodiazepines prescribing: a pretest-posttest study with self-report assessments

Scand J Prim Health Care. 2019 Dec;37(4):418-425. doi: 10.1080/02813432.2019.1663591. Epub 2019 Sep 18.

Authors

Hanne Creupelandt¹, Sibyl Anthierens², Hilde Habraken³, Coral Sirdifield⁴, Aloysius Niroshan Siriwardena⁴, Thierry Christiaens⁵

Affiliations

¹ Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
² Department of Primary Health Care and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
³ BCFI Vzw, p.a. Federaal Agentschap Voor Geneesmiddelen en Gezondheidsproducten Fagg, Brussels, Belgium.
⁴ Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.
⁵ Clinical Pharmacology Research Unit, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium.

Abstract

Objective: Despite guidelines and campaigns, general practitioners (GPs) continue to overprescribe benzodiazepines (BZDs). New approaches to improve prescribing are needed. Using behavior change techniques and tailoring interventions to user characteristics are vital to promote behavior change. This study evaluated the impact of a tailored e-learning module on factors known to determine BZD prescribing within GPs.Design: A pretest-posttest study design with three self-report assessments concerning determinants of BZD prescribing: at baseline, immediately after the module (short term) and six months after completion (long term).Setting: Flanders (Belgium)Intervention: A tailored e-module that focuses on avoiding initial BZD prescriptions and using psychological interventions as an alternative.Subjects: 244 GPsMain outcome measures: Assessed determinants include GPs' attitudes concerning treatment options, perceptions of the patient and self-efficacy beliefs. Readiness to adhere to prescribing guidelines was evaluated through assessing motivation, self-efficacy and implementability of non-pharmacological interventions.Results: A significant and durable impact on determinants of BZD prescribing was observed. GPs underwent desirable changes in attitudes, perceptions and self-efficacy beliefs and these changes remained significant six months later.Conclusion: Tailoring an e-intervention to target group characteristics appears to be successful in promoting behavioral change in experienced GPs. Significant and lasting changes were observed in determinants of prescribing BZDs.Key PointsA tailored e-intervention resulted in significant and long term changes in previously identified determinants of prescribing BZDs. The e-module resulted in a positive impact on GPs' readiness to adhere to BZD prescribing guidance and the way they experience psychosocial consultations. Tailoring an e-intervention to target group characteristics appears to be successful in promoting behavioral change in experienced GPs.

Keywords: Benzodiazepine; continuing medical education; drug prescription; education; family practice; general practitioner.

MeSH terms

Adult
Belgium
Benzodiazepines / administration & dosage
Benzodiazepines / therapeutic use*
Computer-Assisted Instruction / methods*
Education, Medical, Continuing / methods*
Female
General Practitioners / education*
Health Knowledge, Attitudes, Practice
Humans
Inappropriate Prescribing / prevention & control
Male
Middle Aged
Motivation
Practice Patterns, Physicians'
Self Report

Substances

Benzodiazepines

Grants and funding

Developing and providing the e-module was financed by the Federal Public Service – Health, Food Chain Safety and Environment/BelPep (Belgium).