General Practitioners’ Perspectives Over Solutions To Change BZD Prescription Trends – A Qualitative Study

Background: This qualitative study explores General Practitioners’ (GPs) perspectives on solutions to address the problem of excessive prescription of benzodiazepines (BZDs). Over-prescription of BZDs at a primary health care settings is a prevalent issue in the region under analysis, but also elsewhere internationally. GPs are the gatekeepers to these medicines in primary care, but for several subjective, organizational and external reasons, they find it difficult to change current prescription patterns. Simultaneously, GPs recognize the issue of BZD excessive prescription practices, and propose possible solutions to invert the trend.Methods: Qualitative data were collected in seven primary health care centers in an interior and mostly rural region of Portugal. We conducted 12 semi-structured interviews with GPs. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. The themes were integrated and organized into eight axes for action.Results: Solutions proposed by GPs focused on organizational aspects, such as human resources, infrastructure and training (including on withdrawal schemes), alternative approaches, and wider community-based initiatives to counter societal aspects affecting mental health in the identified region. The themes were integrated and organized into eight axes for action.Conclusions: The findings provide an assessment of the priorities to change excessive BZDs prescription, as suggested by the GPs in primary health care settings, and hence reflecting what they consider to be context specific needs. Both experts and multi-stakeholders bottom-up perspectives should be taken into account when proposing new policies and local strategies to tackle current excessive BZD prescription, especially considering the failure of previous strategies to change this well-known public health issue. We consider that our results to be generalizable to all countries where primary health care plays a central role in care provision.Trial registration: ClinicalTrials.gov number NCT04925596