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GPs’ attitudes to benzodiazepine and ‘Z-drug’ prescribing: a barrier to implementation of evidence and guidance on hypnotics

By A. Niroshan Siriwardena, Zubair Qureshi, Steve Gibson, Sarah Collier and Martin Latham


Zaleplon, zolpidem, and zopiclone (‘Z-drugs’)\ud prescribing is gradually rising in the UK, while that of\ud benzodiazepine hypnotics is falling. This situation is\ud contrary to current evidence and guidance on hypnotic\ud prescribing. The aim of this study was to determine\ud and compare primary care physicians’ perceptions of\ud benefits and risks of benzodiazepine and Z-drug use,\ud and physicians’ prescribing behaviour in relation to\ud hypnotics using a cross-sectional survey. In 2005 a\ud self-administered postal questionnaire was sent to all\ud GPs in West Lincolnshire Primary Care Trust. The\ud questionnaire investigated perceptions of benefits and\ud disadvantages of benzodiazepines and Z-drugs. Of the\ud 107 questionnaires sent to GPs, 84 (78.5%) analysable\ud responses were received. Responders believed that Zdrugs\ud were more effective than benzodiazepines in\ud terms of patients feeling rested on waking (P<0.001),\ud daytime functioning (P<0.001), and total sleep time\ud (P = 0.03). Z-drugs were also thought to be safer in\ud terms of tolerance (P<0.001), addiction (P<0.001),\ud dependence (P<0.001), daytime sleepiness (P<0.001),\ud and road traffic accidents (P = 0.018), and were\ud thought to be safer for older people (P<0.001). There\ud were significant differences between GPs’ perceptions\ud of the relative benefits and risk of Z-drugs compared\ud with benzodiazepines. The majority of practitioners\ud attributed greater efficacy and lower side effects to\ud Z-drugs. GPs’ beliefs about effectiveness and safety\ud are not determined by current evidence or national\ud (NICE) guidance which may explain the increase in Zdrug\ud prescribing relative to benzodiazepine prescribing

Topics: L510 Health & Welfare
Publisher: Royal College of General Practitioners
Year: 2006
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