ABSTRACT - Benzodiazepines and analogues (BDZ) are anxiolytics (also known as sedatives) and hypnotics commonly used world-wide. The use of BZD, especially long-term, can result in adverse effects and represents a complex problem for some healthcare systems.
This systematic review aims to identify strategies aiming at the promotion of the rational use of benzodiazepines and analogues across Organization for Economic Co-operation and Development (OECD) countries from 2000 to 2020. We included randomized controlled trials (RCT), quasi-experimental studies, and non-randomized studies: cohort, case-control, cross-sectional, case series and reports. Government and conference reports on regulatory, administrative and educational strategies and interventions aiming at the rational use of benzodiazepines and targeted to consumers, healthcare professionals, healthcare organizations and healthcare systems were also included. A relevant literature search was conducted in PubMed, Scopus, Web of Science® (Web of Knowledge), DANS (Open Grey®), OECD iLibrary and GoogleSchoolar. Two reviewers performed duplicate and independent study selection, data extraction and assessment of the risk of bias. A total of 6,308 records were identified and screened in our search, from which twenty-eight studies were included. Professionals are the preferred target of different interventions. Interventions classified, exclusively or not, as administrative were reported the most in the studies included. Most interventions have demonstrated moderate to large improvements in the prescription, dispensing or utilization of benzodiazepines and analogues.
Heterogeneity regarding the design, delivery, description and report of the strategies and interventions posed a challenge during this review and analysis.
Because strategies and interventions on the rational use of medicines have uncertain effects proper methodological and evidenced-based approaches should be considered in the design, description, implementation and evaluation of these interventions
