Factores que influyen en la prescripción de benzodiacepinas y acciones para mejorar su uso: Un estudio Delphi en médicos de atención primaria

Abstract

Objectives. To identify the factors that affect the prescription of benzodiazepines and similar drugs and the actions that can be taken to reduce their prescription. Design. Consensus method. Delphi technique. Setting. Four primary care areas in Asturias. Participants. 39 doctors from primary care teams agreed voluntarily to take part in the study, and 32 completed the study. They belonged to 20 health centres. Method. They were sent by mail three questionnaires one after the other. The second and third questionnaires were worked out on the basis of the analysis of the information from the replies to the preceding questionnaire. Those who did not send in a reply were reminded by phone. Results. The 5 most influential factors in benzodiazepine prescription were agreed: reduction in the threshold of tolerance of emotional discomfort; increase of the prevalence of pathologies; lack of time in the consulting-room; social and economic conditioning factors; properties of the benzodiazepine family. The 5 most important actions that could reduce prescription of these drugs were agreed: general health education; reduction in case loads; making doctors more conscious of prescribing correctly; strengthening the social support network; doctors fomenting use of effective alternative treatments. Conclusions. The prescription of benzodiazepines and their analogues is a multi-factorial action with social and psychological roots. The action most voted on to reduce their prescription was general health education.