Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial

Background: General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited, and this results in a significant number of chronic users. Long-term BZD use is associat...

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Autores: Socias Buades, Isabel Maria, Leiva, Alfonso, , Bejarano, Ferran, Sempere-Verdú, Ermengol, Vicens-Caldentey, Caterina, Rodríguez-Rincón, Raquel María, Fiol, Francisca, Mengual, Marta, Ajenjo-Navarro, Asunción, Do Pazo Oubiña, Fernando, Mateu, Catalina, Folch, Silvia, Alegret, Santiago, Coll Benejam, Josep Maria, Martin Rabadan Muro, Maria
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/19582
Acceso en línea:https://hdl.handle.net/20.500.13003/19582
Access Level:acceso abierto
Palabra clave:Benzodiazepines
General Practitioners
Humans
Primary Health Care
Feedback
Prescriptions
Retroalimentación
Prescripciones
Humanos
Benzodiazepinas
Atención Primaria de Salud
Médicos Generales
benzodiazepines
adverse effects
primary health care
deprescribing
clinical trial
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spelling Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled TrialSocias Buades, Isabel MariaLeiva, AlfonsoBejarano, FerranSempere-Verdú, ErmengolVicens-Caldentey, CaterinaRodríguez-Rincón, Raquel MaríaFiol, FranciscaMengual, MartaAjenjo-Navarro, AsunciónDo Pazo Oubiña, FernandoMateu, CatalinaFolch, SilviaAlegret, SantiagoColl Benejam, Josep MariaMartin Rabadan Muro, MariaBenzodiazepinesGeneral PractitionersHumansPrimary Health CareFeedbackPrescriptionsRetroalimentaciónPrescripcionesHumanosBenzodiazepinasAtención Primaria de SaludMédicos Generalesbenzodiazepinesadverse effectsprimary health caredeprescribingclinical trialBackground: General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited, and this results in a significant number of chronic users. Long-term BZD use is associated with cognitive impairment, falls with hip fractures, traffic accidents, and increased mortality. The BENZORED IV trial was a hybrid type-1 trial conducted to evaluate the effectiveness and implementation of an intervention to reduce BZD prescription in primary care. The purpose of this qualitative study was to analyze the facilitators and barriers regarding the implementation of the intervention in primary care settings. Methods: A qualitative interview study with 40 GPs from three Spanish health districts. Focus group meetings with GPs from the intervention arm of the BENZORED IV trial were held at primary healthcare centers in the three districts. For sampling purposes, the GPs were classified as high or low implementers according to the success of the intervention measured at 12 months. The Consolidated Framework for Implementation Research (CFIR) was used to conduct the meetings and to code, rate, and analyze the data. Results: Three of the 41 CFIR constructs strongly distinguished between high and low implementers: the complexity of the intervention, the individual Stage of Change, and the key stakeholder's engagement. Seven constructs weakly discriminated between the two groups: adaptability in the intervention, external policy and incentives, implementation climate, relative priority, self-efficacy, compatibility, and engaging a formally appointed implementation leader. Fourteen constructs did not discriminate between the two groups, six had insufficient data for evaluation, and eleven had no data for evaluation. Conclusions: We identified constructs that could explain differences in the efficacy in implementation of the intervention. This information is relevant for the design of successful strategies for implementation of the intervention.MDPI20212021-08-0120212021-08-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/19582reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/195822026-06-22T12:44:07Z
dc.title.none.fl_str_mv Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
title Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
spellingShingle Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
Socias Buades, Isabel Maria
Benzodiazepines
General Practitioners
Humans
Primary Health Care
Feedback
Prescriptions
Retroalimentación
Prescripciones
Humanos
Benzodiazepinas
Atención Primaria de Salud
Médicos Generales
benzodiazepines
adverse effects
primary health care
deprescribing
clinical trial
title_short Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
title_full Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
title_fullStr Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
title_full_unstemmed Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
title_sort Evaluating the Implementation of a Multicomponent Intervention Consisting of Education and Feedback on Reducing Benzodiazepine Prescriptions by General Practitioners: BENZORED Hybrid Type I Cluster Randomized Controlled Trial
dc.creator.none.fl_str_mv Socias Buades, Isabel Maria
Leiva, Alfonso

Bejarano, Ferran
Sempere-Verdú, Ermengol
Vicens-Caldentey, Caterina
Rodríguez-Rincón, Raquel María
Fiol, Francisca
Mengual, Marta
Ajenjo-Navarro, Asunción
Do Pazo Oubiña, Fernando
Mateu, Catalina
Folch, Silvia
Alegret, Santiago
Coll Benejam, Josep Maria
Martin Rabadan Muro, Maria
author Socias Buades, Isabel Maria
author_facet Socias Buades, Isabel Maria
Leiva, Alfonso

Bejarano, Ferran
Sempere-Verdú, Ermengol
Vicens-Caldentey, Caterina
Rodríguez-Rincón, Raquel María
Fiol, Francisca
Mengual, Marta
Ajenjo-Navarro, Asunción
Do Pazo Oubiña, Fernando
Mateu, Catalina
Folch, Silvia
Alegret, Santiago
Coll Benejam, Josep Maria
Martin Rabadan Muro, Maria
author_role author
author2 Leiva, Alfonso

Bejarano, Ferran
Sempere-Verdú, Ermengol
Vicens-Caldentey, Caterina
Rodríguez-Rincón, Raquel María
Fiol, Francisca
Mengual, Marta
Ajenjo-Navarro, Asunción
Do Pazo Oubiña, Fernando
Mateu, Catalina
Folch, Silvia
Alegret, Santiago
Coll Benejam, Josep Maria
Martin Rabadan Muro, Maria
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Benzodiazepines
General Practitioners
Humans
Primary Health Care
Feedback
Prescriptions
Retroalimentación
Prescripciones
Humanos
Benzodiazepinas
Atención Primaria de Salud
Médicos Generales
benzodiazepines
adverse effects
primary health care
deprescribing
clinical trial
topic Benzodiazepines
General Practitioners
Humans
Primary Health Care
Feedback
Prescriptions
Retroalimentación
Prescripciones
Humanos
Benzodiazepinas
Atención Primaria de Salud
Médicos Generales
benzodiazepines
adverse effects
primary health care
deprescribing
clinical trial
description Background: General practitioners (GPs) in developed countries widely prescribe benzodiazepines (BZDs) for their anxiolytic, hypnotic, and muscle-relaxant effects. Treatment duration, however, is rarely limited, and this results in a significant number of chronic users. Long-term BZD use is associated with cognitive impairment, falls with hip fractures, traffic accidents, and increased mortality. The BENZORED IV trial was a hybrid type-1 trial conducted to evaluate the effectiveness and implementation of an intervention to reduce BZD prescription in primary care. The purpose of this qualitative study was to analyze the facilitators and barriers regarding the implementation of the intervention in primary care settings. Methods: A qualitative interview study with 40 GPs from three Spanish health districts. Focus group meetings with GPs from the intervention arm of the BENZORED IV trial were held at primary healthcare centers in the three districts. For sampling purposes, the GPs were classified as high or low implementers according to the success of the intervention measured at 12 months. The Consolidated Framework for Implementation Research (CFIR) was used to conduct the meetings and to code, rate, and analyze the data. Results: Three of the 41 CFIR constructs strongly distinguished between high and low implementers: the complexity of the intervention, the individual Stage of Change, and the key stakeholder's engagement. Seven constructs weakly discriminated between the two groups: adaptability in the intervention, external policy and incentives, implementation climate, relative priority, self-efficacy, compatibility, and engaging a formally appointed implementation leader. Fourteen constructs did not discriminate between the two groups, six had insufficient data for evaluation, and eleven had no data for evaluation. Conclusions: We identified constructs that could explain differences in the efficacy in implementation of the intervention. This information is relevant for the design of successful strategies for implementation of the intervention.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-08-01
2021
2021-08-01
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/19582
url https://hdl.handle.net/20.500.13003/19582
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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