Background: Long-term benzodiazepine dependence carries significant health risks which might be reduced with low-cost patient self-management interventions. A booklet version of one such intervention (Eliminating Medications Through Patient Ownership of End Results; EMPOWER) proved effective in a Canadian clinical trial with older adults. Digitizing such an intervention for electronic delivery and tailoring it to different populations could expand its reach. Accordingly, this article describes the protocol for a randomized controlled trial to test the effectiveness of an electronically-delivered, direct-to-patient benzodiazepine cessation intervention tailored to U.S. military veterans.
Methods: Design: Two-arm individually randomized controlled trial.
Setting: US Veterans Health Administration primary care clinics.
Participants: Primary care patients taking benzodiazepines for three or more months and having access to a smartphone, tablet or desktop computer.
Intervention And Comparator: Participants will be randomized to receive either the electronically-delivered EMPOWER (EMPOWER-ED) protocol or asked to continue to follow provider recommendations regarding their benzodiazepine use (treatment-as-usual).
Measurements: The primary outcomes are complete benzodiazepine cessation and 25% dose reduction, assessed using administrative and self-report data, between baseline and six-month follow-up. Secondary outcomes are self-reported anxiety symptoms, sleep quality, and overall health and quality of life, measured at baseline and 6-month follow-up, and benzodiazepine cessation at 12-month follow-up.
Comments: This randomized controlled trial will evaluate whether the accessibility and effectiveness of a promising intervention for benzodiazepine cessation can be improved through digitization and population tailoring.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468353 | PMC |
http://dx.doi.org/10.1016/j.conctc.2022.100994 | DOI Listing |
Cureus
January 2025
Anesthesiology and Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, NLD.
When a difficult airway is anticipated, awake tracheal intubation can be considered. Usually, low doses of sedatives are administered during this procedure for minimal sedation and anxiolysis, such as midazolam and remifentanil. The newly developed ultra-short-acting benzodiazepine remimazolam has a pharmacokinetic profile that is more suitable for titration during awake tracheal intubation than the long-acting midazolam.
View Article and Find Full Text PDFPharmacol Rep
December 2024
Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Banacha 1B, Warszawa, 02-097, Poland.
Sudden cessation of the drug can cause withdrawal syndrome, discontinuation syndrome, or rebound effect. The common feature of these phenomena is a quick onset, usually limited duration depending on the drug's half-life and remission after restarting the therapy. They are characterized by varying clusters of somatic, autonomic, and psychiatric symptoms.
View Article and Find Full Text PDFBrain Dev
December 2024
Working Group for the Revision of Treatment Guidelines for Pediatric Status Epilepticus/Convulsive Status Epilepticus, Japanese Society of Child Neurology, Tokyo, Japan; Committee for Integration of Guidelines, Japanese Society of Child Neurology, Tokyo, Japan; Division of Child Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan.
Int J Qual Stud Health Well-being
December 2024
Research Unit of Primary Care and Health, Department of General Medicine, Faculty of Medicine, University of Liège, Liège, Belgium.
Introduction: Treatment for substance use disorder (SUD) to benzodiazepine receptor agonists (BZRA) can be challenging and lengthy. BZRA are prescribed for anxiety and insomnia, and though guidelines recommend an initial prescription duration of one to four weeks, this is frequently longer. Understanding the multiple challenges associated with withdrawing from BZRA and exploring the nuance and complexities from the patient's perspective is crucial.
View Article and Find Full Text PDFLife Sci
December 2024
Univ. Lille, Inserm, CHU Lille Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Pharmacology department, F-59000 Lille, France.
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