Benzodiazepines in primary health care: a survey of general practitioners prescribing patterns (1996)

FRANÇAIS :
Ce document présente les résultats d'une enquête par entretien individuel et questionnaire, dans un hôpital général de Mataro (Barcelone, Espagne). Les médecins généralistes ont, en général, une connaissance correcte des indications thérapeutiques des benzodiazépines, mais sont bien moins au courant des dangers potentiels de dépendance et de la façon d'effectuer le sevrage. Le taux de prescription semble être élevé. La majorité des médecins expriment le besoin de ressources alternatives aux benzodiazépines. Aucune association significative n'a été relevée entre les caractéristiques des médecins, comme la formation post-universitaire et le type de pratique, et les connaissances des benzodiazépines ou la fréquence des prescriptions. Du point de vue des auteurs, une meilleure connaissance des benzodiazépines et des alternatives possibles à son usage (facteurs étroitement liés à la formation), associée à la disponibilité de moyens non pharmacologiques, sont susceptibles d'améliorer les qualités des habitudes de prescription des médecins.
ENGLISH :
This paper presents the results of a survey carried out to investigate the benzodiazepine (BZD) prescribing patterns of the general practitioners (GP) in the catchment area of a Drug Dependence Unit located in a general hospital in Mataro (Barcelona, Spain). The aims of the survey were: (i) to obtain descriptive information on the knowledge of the GPs about BZD and its potential for dependence; (ii) to study the frequency of their prescribing; and (iii) to examine different factors linked to their prescribing. The study was carried out using a combination of a personal interview and a self-administered questionnaire. A total of 68 doctors (88.3%) completed the questionnaire. The results show that the GPs have, in general, correct knowledge about the therapeutic indications for BZD prescribing, but are far less aware of their potential to induce dependence and how to manage withdrawal. The rate of prescribing seems to be high. Furthermore, the results of the external check of validity point out that doctors tend to underestimate the number of prescriptions. The majority of GPs express the need for alternative resources to BZD prescribing. No significant associations have been found between doctor's characteristics, such as postgraduate training and type of practice, and their knowledge about BZD and frequency of their prescribing. In our view, a more accurate knowledge about BZD and alternatives to its use, both factors closely linked to training, together with the availability of non-pharmacological resources, are likely to improve the quality of doctors prescribing habits, thus preventing risks such as dependence of BZD.