Equipping physicians for benzodiazepine receptor agonists deprescription in older adults: theory-based development of the BE-SAFE intervention.

DOI
Publisher DOI
PubMed ID
40450448
Abstract
Background
Benzodiazepine receptor agonists (BZRA) are still widely used for sleep problems in older adults despite an unfavourable risk-benefit ratio. The hospital setting presents an opportunity for optimising medication use in older adults. The BE-SAFE project follows a rigorous sequential approach for developing a theory-informed intervention towards BZRA deprescription initiated in the hospital setting in 6 European countries (Belgium, Greece, Norway, Poland, Spain, and Switzerland).Objectives
The objectives of this paper are to describe the development of the physicians' intervention, the results of on the acceptability and perceived feasibility with physicians, and the finalised BE-SAFE intervention.Methods
The intervention was built upon preliminary work and developed in four main steps: selection of behaviour change techniques; identification of existing resources and assessment of needs and preferences of hospital physicians; development of intervention components and modes of delivery; and end-users' evaluation and refinement of intervention.Results
A total of 11 behaviour change techniques were selected, addressing 6 main barriers into a 6-component intervention: senior physician endorsement, training, self-monitoring, deprescription algorithm, communication to patients and other healthcare professionals. These core elements will be delivered allowing local adaptability. Twenty-four physicians evaluated the intervention. They confirmed that the intervention effectively targets the barriers highlighted in preliminary work and provided feedback for improvement regarding clarity and time issues.Conclusions
A 6-component physician's intervention to enhance BZRA deprescription initiated in hospital settings was developed by systematically addressing implementation issues in a theory informed manner. This intervention will be evaluated in a multi-country cluster randomised controlled trial.
Date Issued
2025-09
Publication Type
Article
Subject(s)
Subjects
Benzodiazepine receptor agonists
•
Deprescription
•
Hospital physicians
•
Intervention development
•
Older adults
Language(s)
en
Author(s)
Sibille, François-Xavier
Salbert, Joanna
Tsoutsi, Vagioula
Callegari, Enrico
Dalleur, Olivia
Adda, Tokandji
Agoritsas, Thomas
Dikeos, Dimitris
Salvà, Antoni
Pascual, Begoña
Miralles, Ramon
Wyller, Torgeir Bruun
Patey, Andrea M
Grimshaw, Jeremy M
Wichniak, Adam
Spinewine, Anne
de Saint Hubert, Marie
Additional Credits
Journal
Research in Social and Administrative Pharmacy
Publisher
Elsevier
ISSN
1934-8150
1551-7411
Funding(s)
Access(Rights)
open.access
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