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Review: brief interventions, gradual dose reduction and psychological interventions increase benzodiazepine cessation compared with routine care

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QUESTION

Question:

Are targeted interventions for benzodiazepine cessation more effective than routine care?

Outcomes:

Cessation of benzodiazepine use.

METHODS

Design:

Systematic review with meta-analysis.

Data sources:

PsycLIT, MEDLINE and EMBASE were searched from inception to January 2005 for randomised controlled trials (RCTs). A further search was performed in 2007. Reference lists of identified studies were hand searched.

Study selection and analysis:

Two reviewers appraised studies and selected RCTs comparing: (1) routine care with: brief interventions, gradual dose reduction (GDR) or psychological interventions; (2) GDR with GDR plus psychological interventions or drug substitutions, and looking at the outcome of benzodiazepine cessation. Inclusion criteria: studies including outpatients who had been using benzodiazepines for 3 months or more, minimum of 10 participants in each group at baseline and sufficient information to enable calculation of cessation rates based on intention to treat. Benzodiazepine cessation rates were derived using intention to treat data at post-treatment (defined as first post-treatment assessment) and follow-up (defined as second or subsequent assessments). Fixed effect Mantel–Haenszel odds ratios (OR) were calculated. …

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