Failure to reduce benzodiazepine prescriptions through the implementation of a psychological intervention for insomnia in an Italian mental health service.

Journal: European journal of clinical pharmacology

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Affiliated Institutions:  Laboratory of Evaluation of Quality of Care and Services, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. barbara.davanzo@marionegri.it. Laboratory of Evaluation of Quality of Care and Services, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. Laboratory of Geriatric Epidemiology, Dipartimento di Salute Mentale, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. Department of Mental Health, Teramo, Italy. Azienda Provinciale per i Servizi Sanitari, Trento, Italy.

Abstract summary 

Despite the evidence of higher effectiveness of psychological interventions for insomnia compared to pharmacological ones, drug prescriptions for insomnia remain frequent. This study has assessed patterns of prescriptions of BZDs for insomnia before and after the delivery of a training in psychological interventions to professionals working in the services of a Department of Mental Health in northern Italy.The intervention consisted in two training sessions about psychological interventions for insomnia delivered to professionals of the participating services. The prevalence of users with a prescription of BZDs for insomnia in an index period after the delivery of the training was compared to the prevalence in an index period before the training.Among 727 people assessed for BZDs prescription at pre-intervention, 306 (42.1%, 95% CI 0.39-0.46) had a prescription, and 344 (49.2%, 95% CI 0.45-0.53) had a prescription among 699 people assessed at post-intervention, corresponding to a significant odds ratio of 1.33 to be prescribed with BZDs in the second index period compared to the first one. Psychological interventions were offered to a small group of patients.Prescribing attitudes of BZDs for insomnia were not modified after the training and delivery of a psychological intervention in a mental healthcare outpatient setting. Prescribing habits should be addressed more directly in training, and professionals should be more aware of risks of BZDs assumption. The failure in changing drug prescriptions in this study should prompt more real-world studies of the application of evidence-based strategies, particularly in outpatient mental health settings.

Authors & Co-authors:  D'Avanzo Parabiaghi Galbussera Tettamanti Monti Di Gregorio Zambello Goglio Recla Di Napoli Barbato

Study Outcome 

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Citations :  Riemann D, Espie CA, Altena E et al (2023) The European Insomnia Guideline: an update on the diagnosis and treatment of insomnia 2023. J Sleep Res 32:e14035. https://doi.org/10.1111/jsr.14035
Authors :  11
Identifiers
Doi : 10.1007/s00228-024-03677-7
SSN : 1432-1041
Study Population
Male,Female
Mesh Terms
Other Terms
Benzodiazepine;CBT;Deprescribing;Education;Insomnia;Sleep hygiene
Study Design
Study Approach
Country of Study
Publication Country
Germany