Developing primary care services for high-dose benzodiazepine-dependent patients: A consultation survey

Abstract

Aim: To survey healthcare workers and high-dose benzodiazepine-dependent patients and obtain views on service improvement for managing high-dose benzodiazepine dependency.Methods: Two focus groups were conducted—one consisting of drug workers and high-dose benzodiazepine users and one of drug workers and general practitioners. Groups discussed gaps in service provision for benzodiazepine dependency. Based on a thematic analysis of the discussion, a pilot questionnaire was developed. The final version was sent to all GPs and drug workers in one inner-London borough.Findings: Five themes emerged from the focus groups: definition, impact on society, fear of withdrawal, attitudes and future service developments. The questionnaire was sent to 210 GPs and 21 drug workers. Response rate: 105 (50%) and 13 (62%), respectively. GP respondents had seen 482 high-dose benzodiazepine dependent patients in the preceding month; drug workers had seen 90. Benzodiazepines were considered an important cause of social and physical problems (69% and 75%, respectively). Just 9% of GPs thought that users wanted to withdraw, 23% were not encouraging them to withdraw and only 45% felt confident in carrying out withdrawal. The Department of Health, ‘Orange Guidelines’, had only been read by 53% of GPs. Three service priorities were identified: specialist benzodiazepine drug workers (preferably based in general practices), educational support (including up-to-date guidelines) and clinical psychologist input.Conclusions: Our consultation has identified service development priorities for high-dose benzodiazepine users.