{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:23:05Z","timestamp":1791591785538,"version":"4.3.4"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Fam Pract"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The inappropriate and\/or high prescribing of benzodiazepine and \u2018Z\u2019 drugs (BDZ\u2009+) is a major health concern. The purpose of this study was to determine whether physician or pharmacist led interventions or a simple letter or a personalized prescribing report from a medical regulatory authority (MRA) was the most effective intervention for reducing BDZ\u2009+\u2009prescribing by physicians to patients 65\u00a0years of age or older.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a four-armed, one year, blinded, randomized, parallel-group, investigational trial in Alberta, Canada. Participants were fully licensed physicians (n\u2009=\u2009272) who had prescribed 4 times the defined daily dose (4\u2009+\u2009DDD) or more of any BDZ\u2009+\u2009to an older patient at least once in the 3<jats:sup>rd<\/jats:sup> quarter of 2016. All physician-participants were sent a personalized prescribing profile by the MRA. They were then randomized into four groups that received either nothing more, an additional personal warning letter from the MRA, a personal phone call from an MRA pharmacist or a personal phone call from an MRA physician. The main outcomes were prescribing behavior change of physicians at one year in terms of: change in mean number of older patients receiving 4\u2009+\u2009DDD BDZ\u2009+\u2009and mean dose BDZ\u2009+\u2009prescribed per physician. To adjust for multiple statistical testing, we used MANCOVA to test both main outcome measures simultaneously by group whilst controlling for any baseline differences.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>All groups experienced a significant fall in the total number of older patients receiving 4\u2009+\u2009DDD of BDZ\u2009+\u2009by about 50% (range 43\u201354%) per physician at one year, and a fall in the mean dose of BDZ\u2009+\u2009prescribed of about 13% (range 10\u201316%). However, there was no significant difference between each group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A personalized prescribing report alone sent from the MRA appears to be an effective intervention for reducing very high levels of BDZ\u2009+\u2009prescribing in older patients. Additional interventions by a pharmacist or physician did not result in additional benefit. The intervention needs to be tested further on a more general population of physicians, prescribing less extreme doses of BDZ\u2009+\u2009and that looks at more clinical and healthcare utilization outcomes.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-021-01415-x","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T18:03:54Z","timestamp":1617905034000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Reducing prescribing of benzodiazepines in older adults: a comparison of four physician-focused interventions by a medical regulatory authority"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8221-9812","authenticated-orcid":false,"given":"Nigel","family":"Ashworth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Kain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delaney","family":"Wiebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Hernandez-Ceron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Jess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Mazurek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"issue":"1","key":"1415_CR1","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/s40122-018-0097-6","volume":"7","author":"MR Jones","year":"2018","unstructured":"Jones MR, Viswanath O, Peck J, Kaye AD, Gill JS, Simopoulos TT. 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This was granted because: the CPSA has the legal authority\/obligation under the health professions act of Alberta (Health Professions Act, R.S.A. 2000, c H-7) to intervene regardless, the most onerous intervention arm of the trial (group 4) was our \u2018usual care\u2019 and hence recruiting participants could easily be perceived as coercive (\u201cif you don\u2019t agree to participate you will be allocated to the severest group anyway\u201d), physicians are not seen as disadvantaged and because it was of critical importance for the public good. Also, two arms of the trial investigated the effect of contact with the medical regulator which we couldn\u2019t do if the physicians were aware.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None for any authors. The views and comments expressed in this article are solely the views of the authors and do not necessarily reflect the views of the College of Physicians and Surgeons of Alberta nor the University of Alberta.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"68"}}