Prescription of Benzodiazepines by General Practitioners: Characteristics of Prescribing Trend and Implementation of an Online Educational Program
Condition: Anxiety; Prescription Drug Abuse and Dependency
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      Portugal has the highest benzodiazepine utilization compared to other European countries. The
      high utilization of benzodiazepines has been a concern due to reported side effects of
      long-term use and dependence. Also, these data demonstrate that doctors are possibly choosing
      an inadequate treatment to manage anxious and depressive syndromes.

      This research aims to develop and implement in primary health care units an online
      educational program, following a cluster randomized study design; to study the impact of this
      educational program for changing general practitioner's benzodiazepine prescription pattern;
      to analyze of barriers and facilitators to the implementation of the e-PrimaPrescribe
      program.
    

Detailed description: 
      BZD excessive prescription has long been considered a serious mental health concern in many
      countries. A large number of interventions using different methodologies have been
      implemented to change BZD prescription pattern at primary health care settings, with limited
      positive results.

      The investigators propose the implementation of an effectiveness-implementation hybrid type 1
      intervention. In the study it was developed an online platform, named ePrimaPrescribe, which
      was delivered using a Digital Behavior Change Intervention(DBCI).

      The investigators included all primary health care units from one region in Portugal which
      were randomly allocated to receive a Digital Behavior Change Intervention (DBCI) in the
      format of an online platform to reduce BZD prescription (ePrimaPrescribe) or an online
      platform concerning communication techniques (control).

      The investigators primarily aimed to evaluate the effectiveness of the Digital Behavior
      Change Intervention (DBCI) using as outcome measure the frequency of BZD prescriptions issued
      per month. Secondarily the investigators aimed to analyze the effect of ePrimaprescribe on
      antidepressant prescriptions, to study the effect of ePrimaprescribe on diagnosis definition
      associated with BZD and antidepressant prescription; to perform a cost analysis considering
      the monthly National Health Service spending with BZD co-payment. The investigators finally
      aim to analyze the implementation process using quantitative and qualitative methods.
    

Intervention name(s): ePrimaPrescribe online educational program; ComunicaSaudeMental online educational program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): online training program aiming to change general practitioners' benzodiazepine prescription; online training program aiming to improve general practitioners' communication with mentally ill patients
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Cluster randomized trial
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: Prescribing Patterns; Benzodiazepines; General Practitioners