Identification of Barriers and Needs in the Discontinuation of Benzodiazepine Receptor Agonists in Elderly Patients of a Rural Community-A Qualitative Study.

Abstract

Background/Objectives: The predictors of successful discontinuation of benzodiazepine agonist receptors (BZRA) in elderly patients are not well known due to lack of research on the subject, and there is a need for further investigation, with more focus from the patients' point of view. No previous studies were identified that have been conducted in Portugal on this subject. We proposed to identify the barriers and facilitators in the discontinuation of BZRA from the perceptions of elderly patients under prolonged prescription of BZRA, belonging to the same rural community. The contributions for further research are intended to be the identification of potential intervention targets directed at patients to reduce the prevalence of elderly patients under prolonged prescription of BZRA. Methods: A set of 15 semi-structured interviews with patients under prolonged prescription of BZRA was conducted. Content analysis was done by the main researcher and a reviewer to identify original emerging themes for the two underlying domains. Results: Four themes were identified as barriers to the discontinuation of BZRA: (1) patient characteristics, (2) clinical factors, (3) medication-related factors, and (4) context and external factors. Seven themes were identified as facilitators to the discontinuation of BZRA: (1) motivation, (2) patients' knowledge, (3) perception of BZRA insufficiency, (4) access to written information, (5) access to alternatives, (6) time for decision-making, and (7) attitudes of health professionals. Conclusions: The findings highlight the challenging nature of BZRA discontinuation and the range of barriers and facilitators that impact patients' behaviour towards this purpose. We subdivided the elements identified in two areas, therefore aiming at producing significant knowledge to outline potential intervention targets.