Prescriber Acceptability of a Direct-to-Patient Intervention for Benzodiazepine Receptor Agonist Deprescribing and Behavioural Management of Insomnia in Older Adults

Can J Aging. 2024 Dec;43(4):529-537. doi: 10.1017/S0714980824000114. Epub 2024 Mar 8.

Abstract

Behavioural treatments are recommended first-line for insomnia, but long-term benzodiazepine receptor agonist (BZRA) use remains common and engaging patients in a deprescribing consultation is challenging. Few deprescribing interventions directly target patients. Prescribers' support of patient-targeted interventions may facilitate their uptake. Recently assessed in the Your Answers When Needing Sleep in New Brunswick (YAWNS NB) study, Sleepwell (mysleepwell.ca) was developed as a direct-to-patient behaviour change intervention promoting BZRA deprescribing and non-pharmacological insomnia management. BZRA prescribers of YAWNS NB participants were invited to complete an online survey assessing the acceptability of Sleepwell as a direct-to-patient intervention. The survey was developed using the seven construct components of the theoretical framework of acceptability (TFA) framework. Respondents (40/250, 17.2%) indicated high acceptability, with positive responses per TFA construct averaging 32.3/40 (80.7%). Perceived as an ethical, credible, and useful tool, Sleepwell also promoted prescriber-patient BZRA deprescribing engagements (11/19, 58%). Prescribers were accepting of Sleepwell and supported its application as a direct-to-patient intervention.

Keywords: acceptability; acceptabilité; benzodiazepines; benzodiazépines; comportements en matière de santé; deprescribing; déprescription; health behaviour; participation des patients; patient participation; primary health care; soins de santé primaires.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel
  • Behavior Therapy / methods
  • Deprescriptions*
  • Female
  • GABA-A Receptor Agonists / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • New Brunswick
  • Sleep Initiation and Maintenance Disorders* / drug therapy
  • Surveys and Questionnaires

Substances

  • GABA-A Receptor Agonists