Community pharmacists' experiences with the new tapering program for benzodiazepines and Z-drugs in Belgium.

Abstract

Introduction: Long-term use of benzodiazepines and Z-drugs (BZRA) remains widespread, despite guidelines recommending short-term use and highlighting the harms. On 1 February 2023, a tapering pilot program was launched in Belgium to facilitate deprescribing BZRA by enabling community pharmacists (CPs) to compound capsules with stepwise gradual dose reductions.

Aim: This study aims to explore the CPs' role in this program and the barriers and facilitators they encounter within the program.

Methodology: A cross-sectional survey study evaluating barriers and facilitators was conducted. Participants were randomly selected from the National Database of Community Pharmacies. Results were analyzed descriptively using the Theoretical Domains Framework to identify influences on behaviour change.

Results: Out of 2000 CPs contacted, 328 participants (16.4%) completed the survey. CPs rated their overall satisfaction with the program with a mean score of 7.4/10. Key facilitators identified included the relationship of trust between the patient, CP and general practitioner (GP), the patient's confidence in the CP's role in the program and the specific program elements. The most significant barriers were the CPs' perceived lack of interest from GPs and patients.

Conclusion: The Belgian pilot program has been positively received by CPs. Success factors are the interdisciplinary collaboration (social influences) and the specific elements of the program itself (environmental context and resources). To better understand the factors influencing participation, a qualitative in-depth exploration of CPs, GPs and patients perspectives of the tapering program is recommended. Furthermore, implementation outcomes, the sustainability of BZRA cessation and the benefits patients experience from discontinuation need to be investigated.