ABSTRACT
Objectives
The aim is to pilot a low-touch program for reducing benzodiazepine receptor agonist (BZRA; benzodiazepines, z-drugs) prescriptions among older veterans.
Methods
Pilot randomized controlled trial consists of 2,009 veterans aged ≥ 65 years who received BZRA prescriptions from a Veterans Health Administration pharmacy (Colorado or Montana) during the prior 18 months. Active: Arm 1 was a mailed brochure about BZRA risks that also included information about a free, online cognitive behavioral therapy for the insomnia (CBTI) program. Arm 2 was a mailed brochure (same as arm 1) and telephone reinforcement call. Control: Arm 3 was a mailed brochure without insomnia treatment information. Active BZRA prescriptions at follow-up (6 and 12 months) were measured.
Results
In logistic regression analyses, the odds of BZRA prescription at 6- and 12-month follow-ups were not significantly different for arm 1 or 2 (active) versus arm 3 (control), including models adjusted for demographics and prescription characteristics (p-values >0.36).
Conclusions
Although we observed no differences in active BZRA prescriptions, this pilot study provides guidance for conducting a future study, indicating a need for a more potent intervention. A full-scale trial testing an optimized program would provide conclusive results.
Clinical Implications
Mailing information about BZRA risks and CBTI did not affect BZRA prescriptions.
Clinical Implications
Clinicians and healthcare organizations interested in reducing BZRA use in older veterans should consider interventions that are more potent than a mailed brochure about the risks of BZRA and information about accessing CBTI.
The addition of a telephone reinforcement call to the mailed brochure was not sufficient to reduce BZRA prescriptions.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available from the corresponding author, SM, upon reasonable request.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/07317115.2022.2130849