{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:31:02Z","timestamp":1740162662617,"version":"3.37.3"},"reference-count":36,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shanghai Key Laboratory of Psychotic Disorders","award":["13DZ2260500"],"award-info":[{"award-number":["13DZ2260500"]}]},{"DOI":"10.13039\/501100014175","name":"Shanghai Municipal Health and Family Planning Commission","doi-asserted-by":"publisher","award":["20184Y0134"],"award-info":[{"award-number":["20184Y0134"]}],"id":[{"id":"10.13039\/501100014175","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171483","82171485"],"award-info":[{"award-number":["82171483","82171485"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Mental Health Center","award":["CRC2018YB02"],"award-info":[{"award-number":["CRC2018YB02"]}]},{"name":"Clinical Research Center, Shanghai Jiao Tong University School of Medicine","award":["DLY201818"],"award-info":[{"award-number":["DLY201818"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Benzodiazepine receptor agonists (BZRAs), which include benzodiazepines and Z-drugs, are the most commonly prescribed psychotropic drugs worldwide, and their inappropriate use places a significant burden on public health. Given the widespread use of BZRAs in psychiatric settings, this condition may result from doctors\u2019 improper prescribing. Researchers have developed an electronic intervention system to assist psychiatrists in prescribing BZRAs appropriately. This study aims to determine the efficacy and utility of electronic intervention in reducing improper BZRAs prescriptions in real-world psychiatric outpatient settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>A multicentre randomised controlled research study will be conducted in real-world settings with licensed psychiatrists with prescription qualifications from five of Chinese most significant regional hospitals that provide high-quality mental healthcare. Participants will be 1:1 randomly assigned to receive a 3-month electronic intervention (11 related information pushing and 3 online lectures) or be placed on a waiting list. The primary outcome is the change in the proportion of inappropriate BZRAs prescriptions between the baseline period (3\u2009months before the intervention) and 3\u2009months after the intervention. Secondary outcomes will be examined at baseline, the third month and the sixth month. The secondary outcomes include psychiatrists\u2019 knowledge and attitudes about appropriate BZRAs prescription, the associated side effects of BZRAs among patients and self-efficacy. To measure the utility, intervention assessment and system utilisation data from the intervention group were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The institutional review board and ethics committees of Shanghai Mental Health Center, Second Xiangya Hospital, West China Hospital, Guangji Hospital and Wuhan Mental Health Center approved the study. After the study is completed, the results will be published in peer-reviewed journals or presented at conferences. If the educational materials are effective, they are available to the general public.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03724669\">NCT03724669<\/jats:ext-link>; Pre-results.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2021-055341","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T16:02:24Z","timestamp":1649174544000},"page":"e055341","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and utility of an electronic intervention for appropriate benzodiazepine and Z-drugs prescription in psychiatric clinics: protocol for a multicentric, real-world randomised controlled trial in China"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct03724669","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2432-3106","authenticated-orcid":false,"given":"Xiaomin","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujian","family":"Ye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajun","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7891-3297","authenticated-orcid":false,"given":"Youwei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haifeng","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4656-2936","authenticated-orcid":false,"given":"Na","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"2023030803151910000_12.4.e055341.1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1001\/jamapsychiatry.2014.1763","article-title":"Benzodiazepine use in the United States","volume":"72","author":"Olfson","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"2023030803151910000_12.4.e055341.2","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1056\/NEJMra1611832","article-title":"Treatment of benzodiazepine dependence","volume":"376","author":"Soyka","year":"2017","journal-title":"N Engl J Med"},{"key":"2023030803151910000_12.4.e055341.3","doi-asserted-by":"publisher","DOI":"10.5698\/1535-7597-16.1.48"},{"key":"2023030803151910000_12.4.e055341.4","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2175"},{"key":"2023030803151910000_12.4.e055341.5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/bdi.12609","article-title":"Canadian network for mood and anxiety treatments (CANMAT) and International Society for bipolar disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder","volume":"20","author":"Yatham","year":"2018","journal-title":"Bipolar Disord"},{"key":"2023030803151910000_12.4.e055341.6","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-018-0255-3"},{"key":"2023030803151910000_12.4.e055341.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38623.768588.47"},{"key":"2023030803151910000_12.4.e055341.8","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s40268-017-0207-7","article-title":"Benzodiazepines and Z-Drugs: an updated review of major adverse outcomes reported on in epidemiologic research","volume":"17","author":"Brandt","year":"2017","journal-title":"Drugs R&D"},{"key":"2023030803151910000_12.4.e055341.9","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.ajp.2019.07.041","article-title":"Deprescribing of benzodiazepines and Z-drugs amongst the psychiatric patients of a tertiary care hospital","volume":"44","author":"Shilpa","year":"2019","journal-title":"Asian J Psychiatr"},{"key":"2023030803151910000_12.4.e055341.10","doi-asserted-by":"crossref","first-page":"69S","DOI":"10.1111\/j.1365-2125.1979.tb04668.x","article-title":"Psychomotor changes during initial day of benzodiazepine medication","volume":"7","author":"Wittenborn","year":"1979","journal-title":"Br J Clin Pharmacol"},{"key":"2023030803151910000_12.4.e055341.11","doi-asserted-by":"crossref","first-page":"487","DOI":"10.5664\/jcsm.27286","article-title":"Clinical guideline for the evaluation and management of chronic insomnia in adults","volume":"4","author":"Schutte-Rodin","year":"2008","journal-title":"J Clin Sleep Med"},{"key":"2023030803151910000_12.4.e055341.12"},{"key":"2023030803151910000_12.4.e055341.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03563.x"},{"key":"2023030803151910000_12.4.e055341.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2014.04.008"},{"key":"2023030803151910000_12.4.e055341.15","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3825"},{"key":"2023030803151910000_12.4.e055341.16","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.eurpsy.2011.11.003","article-title":"Do benzodiazepines still deserve a major role in the treatment of psychiatric disorders? A critical reappraisal","volume":"28","author":"Dell'osso","year":"2013","journal-title":"Eur Psychiatry"},{"key":"2023030803151910000_12.4.e055341.17","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s40266-018-0544-4","article-title":"Deprescribing benzodiazepines in older patients: impact of interventions targeting physicians, pharmacists, and patients","volume":"35","author":"Ng","year":"2018","journal-title":"Drugs Aging"},{"key":"2023030803151910000_12.4.e055341.18","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.5535","article-title":"Patient-centered care interventions to reduce the inappropriate prescription and use of benzodiazepines and z-drugs: a systematic review","volume":"6","author":"Mokhar","year":"2018","journal-title":"PeerJ"},{"key":"2023030803151910000_12.4.e055341.19","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1111\/add.14981","article-title":"Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis","volume":"115","author":"Lynch","year":"2020","journal-title":"Addiction"},{"key":"2023030803151910000_12.4.e055341.20","first-page":"Cd009652","article-title":"Psychosocial interventions for benzodiazepine harmful use, abuse or dependence","volume":"5","author":"Darker","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2023030803151910000_12.4.e055341.21","doi-asserted-by":"crossref","unstructured":"Neves IT , Oliveira JSS , Fernandes MCC . Physicians' beliefs and attitudes about benzodiazepines: a cross-sectional study. BMC Fam Pract 2019;20:71.","DOI":"10.1186\/s12875-019-0965-0"},{"key":"2023030803151910000_12.4.e055341.22","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1001\/jamapsychiatry.2014.2190","article-title":"Why are benzodiazepines not yet controlled substances?","volume":"72","author":"Moore","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"2023030803151910000_12.4.e055341.23","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.drugalcdep.2015.11.010","article-title":"Prescribed quantities, and trajectory of multiple prescriber episodes for benzodiazepines: a 2-year cohort study","volume":"158","author":"Okumura","year":"2016","journal-title":"Drug Alcohol Depend"},{"key":"2023030803151910000_12.4.e055341.24","doi-asserted-by":"crossref","unstructured":"Liu C , Wang L , Zhao Q . Factors related to health-related quality of life among Chinese psychiatrists: occupational stress and psychological capital. BMC Health Serv Res 2015;15:20.","DOI":"10.1186\/s12913-015-0677-7"},{"key":"2023030803151910000_12.4.e055341.25","doi-asserted-by":"publisher","DOI":"10.1177\/002076409604200202"},{"key":"2023030803151910000_12.4.e055341.26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001362"},{"key":"2023030803151910000_12.4.e055341.27","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5066"},{"key":"2023030803151910000_12.4.e055341.28","doi-asserted-by":"publisher","DOI":"10.1080\/08870449808407422"},{"key":"2023030803151910000_12.4.e055341.29","doi-asserted-by":"crossref","first-page":"307","DOI":"10.5664\/jcsm.6470","article-title":"Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of sleep medicine clinical practice guideline","volume":"13","author":"Sateia","year":"2017","journal-title":"J Clin Sleep Med"},{"key":"2023030803151910000_12.4.e055341.30","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12594"},{"key":"2023030803151910000_12.4.e055341.31","doi-asserted-by":"publisher","DOI":"10.3109\/13651501.2012.667114"},{"key":"2023030803151910000_12.4.e055341.32","unstructured":"National Institute for Health and Care Excellence: Clinical Guidelines . Generalised anxiety disorder and panic disorder in adults: management. London: National Institute for Health and Care Excellence (UK), 2019."},{"key":"2023030803151910000_12.4.e055341.33","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s40261-018-0648-y","article-title":"Translating benzodiazepine utilization data into meaningful population exposure: integration of two metrics for improved reporting","volume":"38","author":"Brandt","year":"2018","journal-title":"Clin Drug Investig"},{"key":"2023030803151910000_12.4.e055341.34","first-page":"177","article-title":"Optimistic self-beliefs: assessment of general perceived self-efficacy in thirteen cultures","volume":"3","author":"Schwarzer","year":"1997","journal-title":"World Psychology"},{"key":"2023030803151910000_12.4.e055341.35","first-page":"191","article-title":"Reliability and validation of the general self-efficacy scale","volume":"19","author":"Shi","year":"2005","journal-title":"Chinese Mental Health J"},{"key":"2023030803151910000_12.4.e055341.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2710.2005.00674.x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-055341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T12:23:24Z","timestamp":1678278204000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-055341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,12]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjopen-2021-055341"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-055341","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}