{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:51Z","timestamp":1772169051429,"version":"3.50.1"},"reference-count":34,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005481","name":"University of York","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005481","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Carlos III Health Institute of the Ministry of Economy and Competitiveness","award":["PS09\/00947"],"award-info":[{"award-number":["PS09\/00947"]}]}],"content-domain":{"domain":["hrbopenresearch.org"],"crossmark-restriction":false},"short-container-title":["HRB Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    In Spain, long-term use of benzodiazepine is prevalent in 7% of the population; however, this longer-term use lacks clinical benefits, costs \u20ac90million per year and side-effects further add extra cost through adverse health outcomes. This study aims to estimate the cost-effectiveness of primary care services stepped dose reduction of long-term benzodiazepines using either Structured Interview with Follow-up (SIF) or Without Follow-up (SIW), compared to Treatment as Usual (TAU).\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Design:<\/ns4:bold>\n                    Cost-effectiveness analysis was conducted alongside randomised control utilizing data from three arm cluster randomized trial.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Setting:<\/ns4:bold>\n                    Primary care.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Participants:<\/ns4:bold>\n                    75 general practitioners were randomised to one of the three arms (TAU, SIW, SIF).\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Measurements:<\/ns4:bold>\n                    Cost and Cost per Quality-Adjusted Life Year (QALY)\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    Compared to usual care, providing SIW per participant costs an additional \u20ac117.94 and adding patient follow-up, \u20ac218.4. As a result of intervention, participants showed a gain of, on average, for SIW 0.0144 QALY (95% CI -0.0137 to 0.0425) and for SIF 0.0340 QALYs (0.0069 to 0.0612). The Incremental Cost Effectiveness Ratio was \u20ac8190.28\/QALY (SIW) and \u20ac6423.53\/QALY (SIF). At the Spanish reimbursement threshold (\u20ac45,000 per QALY) the chance interventions are cost effective is 79.8% for SIW and 97.7% for SIF.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Brief structured interventions to discontinue long-term benzodiazepine use represent value for money, particularly with scheduled follow-up appointments, and would represent a cost-effective investment by the Spanish healthcare to reduce prevalence of long-term use.\n                  <\/ns4:p>","DOI":"10.12688\/hrbopenres.13049.1","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T08:55:10Z","timestamp":1591174510000},"page":"33","update-policy":"https:\/\/doi.org\/10.12688\/hrbopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost-effectiveness of brief structured interventions to discontinue long-term benzodiazepine use: an economic analysis alongside a randomised controlled trial"],"prefix":"10.12688","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1421-2966","authenticated-orcid":false,"given":"Dominic","family":"Tr\u00e9pel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shehzad","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Gilbody","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Leiva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Mcmillan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7875-4193","authenticated-orcid":false,"given":"Ferran","family":"Bejarano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ermengol","family":"Sempere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-625X","authenticated-orcid":false,"given":"Caterina","family":"Vicens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"408-413","DOI":"10.1016\/j.pharma.2009.07.001","article-title":"Benzodiazepine dependence: focus on withdrawal syndrome.","volume":"67","author":"N Authier","year":"2009","journal-title":"Ann Pharm Fr."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"817-825","DOI":"10.4088\/jcp.v63n0912","article-title":"Use of psychotropic medication in the general population of France, Germany, Italy, and the United Kingdom.","volume":"63","author":"M Ohayon","year":"2002","journal-title":"J Clin Psychiatry."},{"key":"ref-3","article-title":"Etat des lieux de la consommation des benzodiazepines en France","year":"2012"},{"key":"ref-4","article-title":"British National Formulary","year":"2013"},{"key":"ref-5","article-title":"Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia. 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Economic analysis funded by University of York. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}