{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:21:56Z","timestamp":1791174116048,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To increase our understanding of which factors contribute to long\u2010term benzodiazepine receptor agonist (BZRA) use for insomnia in primary care, from a patients', general practitioners' (GP) and pharmacists' perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Qualitative research following a grounded theory approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Primary care in Belgium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Twenty\u2010four participants were interviewed, including nine patients, six GPs and nine pharmacists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>In\u2010depth, semistructured interviews with iterative cycles of data collection and analysis. Transcripts were analysed using the framework method. Thematic findings were interpreted in the context of the Theoretical Domains Framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A reflexive relation was identified between views about hypnotic use at the level of society, healthcare and patients. Behaviour change appeared to depend strongly on context and social influence, including a need for supporting relationships by all stakeholders. Six key messages captured factors that contribute to long\u2010term BZRA use for insomnia in primary care: societal beliefs as a game changer, the opportunity of nonpharmacological treatment, collaborative primary care, patient\u2010centred goals, informed consent and self\u2010management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term BZRA use for insomnia is a complex and multifaceted public health problem that is not adequately addressed in primary care at this time. Although primary care professionals in this study found discontinuation of long\u2010term BZRA use relevant to the patient's health, many organisational and personal barriers were reported. Moreover, the current social and healthcare context is not empowering patients and professionals to reduce long\u2010term BZRA use for insomnia. Specifically, for primary care, all stakeholders reported the need for a nonmedicalised relationship between the patient and GP to lower prescribing rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>The Flemish Patient Platform, a patient representative organisation, assisted with recruitment by launching a call for participants in their newsletter and volunteered to disseminate the results. The call for recruitment was also published online in social media groups regarding insomnia and via posters in public pharmacies. Patients or public were not involved in designing or conducting the interview study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.13888","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T02:43:06Z","timestamp":1697596986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Reducing long\u2010term use of benzodiazepine receptor agonists: In\u2010depth interview study with primary care stakeholders"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3170-0195","authenticated-orcid":false,"given":"Kristien","family":"Coteur","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care Academic Center for General Practice, KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6235-1752","authenticated-orcid":false,"given":"Sanne","family":"Peters","sequence":"additional","affiliation":[{"name":"Division of Medicine, Dentistry and Health Sciences School of Health Sciences, The University of Melbourne Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5355-4451","authenticated-orcid":false,"given":"Pieter","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Academic Center for General Practice, KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-9613","authenticated-orcid":false,"given":"Birgitte","family":"Schoenmakers","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Academic Center for General Practice, KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2976-6611","authenticated-orcid":false,"given":"Marc","family":"Van Nuland","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Academic Center for General Practice, KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1611832"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40268-017-0207-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.1150"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2015.09.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502518"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e16215"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/20451253221082386"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-03007-7"},{"key":"e_1_2_11_10_1","volume-title":"Medicines Associated with Dependence or Withdrawal Symptoms: Safe Prescribing and Withdrawal Management for Adults","author":"NICE","year":"2022"},{"key":"e_1_2_11_11_1","volume-title":"Richtlijn Voor Goede Medische Praktijkvoering: Aanpak van Slaapklachten En Insomnie Bij Volwassenen in de Eerste Lijn","author":"Cloetens H","year":"2018"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/20451253211011874"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgpopen18X101626"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-021-01510-z"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40271-016-0182-z"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015959"},{"key":"e_1_2_11_17_1","unstructured":"International Narcotics Control Board.Psychotropic Substances 2021. 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