TY - JOUR
KW - Aged
KW - Anti-Anxiety Agents/administration & dosage/adverse effects
KW - Benzodiazepines/administration & dosage/adverse effects
KW - Humans
KW - Primary Health Care/methods
KW - Substance Withdrawal Syndrome/therapy
KW - Substance-Related Disorders/rehabilitation
KW - Harm Reduction
KW - Substance-Related Disorders
KW - Benzodiazepines
AU - Josefina Aguiluz
AU - Matias Alvarez
AU - Eduardo Pimentel
AU - Carolina Abarca
AU - Philippa Moore
A1 - 
AB - Benzodiazepines are widely used in primary health care, and their prolonged use is an important problem given the medical consequences particularly in older adults, such as dependence, cognitive impairment, and risk of falls, among others. Primary care doctors generally have few tools to help with managing withdrawal from benzodiazepines. We conducted a review of the best available evidence on practical strategies to avoid dependence at the time of the initial prescription, and to help the patient with prolonged and probably dependent use. We found ten relevant systematic reviews showing evidence in favor of the use of multifaceted prescription strategies, gradual dose reduction, standardized letters, standardized counseling, pharmacotherapy and cognitive behavioral psychotherapy. For benzodiazepine withdrawal, a simple strategy that can be effective and long-lasting is to inform patients of the need to reduce consumption, giving them in writing the withdrawal guideline, indicating the possible effects of withdrawal and its solution. Given the available evidence, an integrated and step-by-step model is proposed for the management of the benzodiazepine user, from prescription to withdrawal.
AD - Facultad de Medicina, Pontificia Universidad Catolica, Santiago, Chile. Address: Los Almendros 9183, La Florida, Santiago, Chile, CP: 8240000. Email: karolabarca84@hotmail.com.; Facultad de Medicina, Pontificia Universidad Catolica, Santiago, Chile.; Facultad de Medicina, Pontificia Universidad Catolica, Santiago, Chile.; Centro de Salud Familiar Ancora San Alberto Hurtado, Puente Alto, Santiago, Chile; Departamento de Medicina Familiar, Pontificia Universidad Catolica de Chile, Santiago, Chile.; Departamento de Medicina Familiar, Pontificia Universidad Catolica de Chile, Santiago, Chile.
BT - Medwave
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 1
CY - Chile
DO - 10.5867/medwave.2018.01.7159
IS - 1
JF - Medwave
LA - spa; eng
M1 - Journal Article
N2 - Benzodiazepines are widely used in primary health care, and their prolonged use is an important problem given the medical consequences particularly in older adults, such as dependence, cognitive impairment, and risk of falls, among others. Primary care doctors generally have few tools to help with managing withdrawal from benzodiazepines. We conducted a review of the best available evidence on practical strategies to avoid dependence at the time of the initial prescription, and to help the patient with prolonged and probably dependent use. We found ten relevant systematic reviews showing evidence in favor of the use of multifaceted prescription strategies, gradual dose reduction, standardized letters, standardized counseling, pharmacotherapy and cognitive behavioral psychotherapy. For benzodiazepine withdrawal, a simple strategy that can be effective and long-lasting is to inform patients of the need to reduce consumption, giving them in writing the withdrawal guideline, indicating the possible effects of withdrawal and its solution. Given the available evidence, an integrated and step-by-step model is proposed for the management of the benzodiazepine user, from prescription to withdrawal.
PP - Chile
PY - 2018
SN - 0717-6384; 0717-6384
SP - e7159
T1 - How to face a patient with benzodiazepine dependence in primary health care? Strategies for withdrawal
T2 - Medwave
TI - How to face a patient with benzodiazepine dependence in primary health care? Strategies for withdrawal
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 29385122
U3 - 10.5867/medwave.2018.01.7159
VL - 18
VO - 0717-6384; 0717-6384
Y1 - 2018
Y2 - Jan 30
ER -