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Background: Contrary to short-term use, long-term benzodiazepine use is undesirable. Nevertheless, its prevalence is high. To prevent long-term use, it is important to know which short-term users are at risk of becoming long-term users.Objectives: The purpose of the present study was to identify patient-related factors of long-term versus short-term use of benzodiazepines.Methods: A cross-sectional study was carried out in family practices among users of benzodiazepines with regard to DSM-IV diagnosis, coping and psychosocial characteristics,. In a multivariate logistic regression analysis, long-term use of benzodiazepines was the dependent variable.Results: A total of 164 short-term and 158 long-term benzodiazepine users participated in the study. Having a DSM-IV disorder and psychiatric co-morbidity, being older, less educated, lonely and using more avoidance coping behaviour was associated with long-term use of benzodiazepines compared with short-term use.Conclusion: The associations found point to possibilities to reduce long-term benzodiazepine use, for example if patients with these characteristics are treated with the alternatives to benzodiazepines or are monitored closely for a short period after being prescribing benzodiazepines. [ABSTRACT FROM AUTHOR]

Background: Predictors of benzodiazepine discontinuation after sending a discontinuation letter by the family practitioner have not been established sufficiently., Objective: To identify predictors of short- and long-term discontinuation of benzodiazepine use and relapse in use after a minimal intervention with a discontinuation letter followed by an offer for an evaluation consultation., Methods: Predictors of benzodiazepine discontinuation and relapse in use were studied by logistic regression analysis and survival analysis within a family practice population of long-term benzodiazepine users (n = 1707) addressed by a discontinuation letter and followed for 21 months., Results: A lower baseline prescription, a shorter duration of use, male gender and use of an agent with a half-life time <24 hours were predictive of complete discontinuation in the short (6 months) and long term (21 months). Multiple agent use at baseline, use of antidepressants at 6 months and benzodiazepine type (anxiolytic/hypnotic) at baseline predicted relapse. Attendance at an evaluation consultation 3 months after the letter was sent was not predictive of discontinuation or relapse., Conclusions: Amount of baseline use and duration of use are the main determinative characteristics of successful discontinuation. The discontinuation letter intervention is suitable for use with a broad group of long-term benzodiazepine users in family practice and can be used as a first step within a stepped care approach to decrease long-term benzodiazepine use.

Background: Long-term results of minimal intervention strategies to cut down benzodiazepine use are not available., Objective: To evaluate the relapse rate over a two-year period and to search for predictors of relapse among patients who quit benzodiazepine use after receiving a discontinuation letter., Methods: Baseline assessment and prospective monitoring of the medical records of 109 patients who quit long-term benzodiazepine use after a minimal intervention strategy in general practice., Results: After 819 +/- 100 days of follow-up, 53 (49%) patients had remained completely abstinent. Two independent predictors of relapse were identified by Cox regression analysis: use of more than 10 mg diazepam equivalent (RR = 2.4 [1.2 - 4.7]) and poor general health perception (RR = 0.98 [0.97 - 0.99])., Conclusion: Short-term success rates after a minimal intervention were maintained well during long-term follow-up. High-dose users have the highest risk of relapse.