TOPLINE:
The use of an electronically-delivered self-management intervention called EMPOWER-ED was associated with a fivefold greater likelihood of benzodiazepine (benzo) cessation compared with usual care in long term benzo users, a new study showed.
METHODOLOGY:
- Researchers conducted a two-arm randomized clinical trial between 2022 and 2024 at Veterans Health Administration primary care clinics and included 161 patients (mean age, 62 years; 83% men; 89% White individuals) who had been taking benzos for at least 3 months.
- The intervention group (n = 82) accessed the EMPOWER-ED materials through various platforms, including by smartphone, desktop, or tablet, and received self-assessment tools, information on benzo-related risks, peer success stories, and personalized tapering schedules.
- The control group (n = 79) followed their usual benzo regimen on the basis of clinician recommendations. Both groups received 30- to 45-minute telephone interviews at baseline and 6-month follow-up assessment; the retention rate was 97.5%.
- The co-primary outcomes were complete benzodiazepine cessation and a 25% or greater dose reduction at 6 months. Secondary outcomes included self-reported anxiety symptoms, sleep quality, and overall health/quality of life.
TAKEAWAY:
- The EMPOWER-ED group had significantly higher odds of complete benzo cessation than the control group (odds ratio [OR], 5.3; 95% CI, 1.1-25.1).
- Although the intervention group’s odds of achieving a > 25% dose reduction was twice that of the control group’s odds (OR, 2.5; 95% CI, 0.9-6.9), the difference was deemed not significant.
- Analysis of secondary outcomes showed no statistically significant between-group differences in anxiety symptoms, sleep quality, or overall health and quality-of-life measures.
IN PRACTICE:
“The study…offers encouraging evidence that simple, low-cost electronic tools can be distributed at scale and can also foster patient autonomy and engagement for patients willing to access these resources,” the authors of an accompanying editorial wrote.
The intervention “can enable patients to come to clinic visits better informed and prepared to make a change,” they added.
SOURCE:
This study was led by Keith Humphreys, PhD, Veterans Affairs Palo Alto Health Care System, Menlo Park, California. The accompanying editorial was led by Marlise Pierre-Wright, MD, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago. Both were published online on January 14 in JAMA Network Open.
LIMITATIONS:
The researchers could not determine whether patients switched to receiving prescriptions from clinicians outside the Veteran Affairs system as the prescribing data came from Veterans Affairs records. Benzodiazepine use through other measures such as diversion was not captured, potentially affecting the accuracy of medication data for some patients. Additionally, the intervention was specifically tailored for veterans and might not be generalizable for other populations.
DISCLOSURES:
This study was funded by the US Department of Veterans Affairs Health Services Research and Development Service. Humphreys reported serving on the board of Indivior PLC. The other investigators and Pierre-Wright reported having no relevant financial relationships. The other editorialists reported receiving grants from the National Institute on Aging; the Agency for Healthcare Research and Quality; the National Heart, Lung, and Blood Institute; and the National Institute of Neurological Disorders and Stroke.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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