Different Attitudes of Patients and Psychiatrists Toward Benzodiazepine Treatment

Yasushi Kawamata; Norio Sugawara; Masamichi Ishioka; Kazutoshi Kubo; Katsuji Suzuki; Akira Fujii; Hanako Furukori; Taku Nakagami; Norio Yasui-Furukori; Kazutaka Shimoda

doi:10.2147/NDT.S314440

Different Attitudes of Patients and Psychiatrists Toward Benzodiazepine Treatment

Neuropsychiatr Dis Treat. 2021 Jun 15:17:1927-1936. doi: 10.2147/NDT.S314440. eCollection 2021.

Authors

Yasushi Kawamata¹, Norio Sugawara^{1

2}, Masamichi Ishioka³, Kazutoshi Kubo⁴, Katsuji Suzuki⁵, Akira Fujii⁶, Hanako Furukori⁷, Taku Nakagami⁸, Norio Yasui-Furukori^{1

2}, Kazutaka Shimoda¹

Affiliations

¹ Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan.
² Department of Neuropsychiatry, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
³ Department of Psychiatry, Minato Hospital, Hachinohe, Japan.
⁴ Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan.
⁵ Department of Psychiatry, Aomori Central Hospital, Aomori, Japan.
⁶ Department of Neuropsychiatry, Mutsu General Hospital, Mutsu, Japan.
⁷ Department of Neuropsychiatry, Kuroishi-Akebono Hospital, Kuroishi, Japan.
⁸ Department of Psychiatry, Nakagami Mental Clinic, Ohdate, Japan.

Abstract

Background: 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: anxiolytics; belief; benzodiazepine receptor agonist; dependence; hypnotics.

Grants and funding

The authors received no specific funding for this work.