Analysis of the prescription of benzodiazepines by family physicians in a sample in Rio de Janeiro

Abstract

This qualitative study researched the determinants influencing family physician’s decision on benzodiazepine prescription in a primary care setting, in the city of Rio de Janeiro. An analysis was sought to be elaborated, on how the prescription is negotiated between physician and user. Twelve general practitioners settled in primary care were recruited, gave acceptance signing free and informed consent form, responding to a semi-structured questionnaire that was recorded and transcribed verbatim for analysis, from August to December 2017. The questionnaire addressed physicians' perception of complaints in benzodiazepines users, and alternatives offered instead of medicines. Anxiety and insomnia were cited as the most frequent reasons for use. There was also mention of nonspecific somatic complaints, chronic pain, arterial hypertension, and dependence. Most physicians proposed the therapeutic alliance as a mechanism for offering alternatives to reduce the chronic use of benzodiazepines, despite this intervention achieving a low success rate. Longitudinal care was evidenced as a guiding principle. The analysis of the meanings attributed to BZD, as unveiled in this work, promotes a discussion about the place of medication in culture and its consequences in the approach to psychological and mental suffering.