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Representations Concerning Long-Term Use of Benzodiazepines Hypnotics, by Patients Over 65, Treated in General Practice. A Qualitative Study Using Individual Interviews

Laporte C, Vorilhon P, Gibiat P1, Marty L, Authier N, Bottet A, De Rosa M, Dibao-Dina C, Vicens C, Llorca PM, Tanguy G

Aim: France is one of the largest consumers of hypnotic benzodiazepines (BZD) and anxiolytics. This consumption has increased in the last few years, especially for older patients. Duration of prescription is greater than in recommendations. The great majority of prescriptions emanate from general practitioners (GPs). The aim of this study was to explore patients’ perception of long-term BZD use for hypnotic purposes in subjects over 65 years old.

Methods: A qualitative study by partially-directed individual interview was used. A diversified panel of patients was selected. There was a full transcription of interviews. A thematic analysis was then carried out by several researchers. The interviews were continued to the point of data saturation.

Results: Fourteen patients were interviewed between December 2012 and April 2013. In this study, participants bore witness to their strong attachment to their BZD hypnotic. The initial prescription is related to an important life event. Benefits extended beyond relief of initial symptoms, becoming an important element of daily comfort, rendering withdrawal difficult to imagine. However, patients were often conscious of the risks of taking BZD. Patients perceived repeated prescription by GPs as a guarantee of the drug’s innocuousness. Very few GPs spontaneously proposed cessation of treatment.

Conclusions: Withdrawal must take into account the psychological dependence and fragility of elderly patients. The GP, with his knowledge of the patient’s environment, could take a central role in prudent initiation and in directed withdrawal when this is necessary. Keywords: Aged, Benzodiazepines, General