Barriers to nonpharmacologic treatments for stress, anxiety, and insomnia: family physicians' attitudes toward benzodiazepine prescribing

Abstract

Objective: To explore the attitudes of FPs toward benzodiazepine (BZD) prescribing and the perceived barriers to nonpharmacologic approaches to managing stress, anxiety, and insomnia.

Design: A questionnaire including 32 statements about treatment of insomnia, stress, and anxiety.

Setting: Local quality groups for FPs in Belgium.

Participants: A total of 948 Belgian FPs.

Main outcome measures: Barriers to using nonpharmacologic approaches in family practice.

Results: We identified 3 different groups of FPs according to their attitudes about BZD prescribing. A first relatively big group of FPs (39%) were not really concerned about the risks of BZD prescribing. Those in the second group (17%) were aware of the problems associated with BZDs, but did not perceive it to be their role to use nonpharmacologic approaches in family practice. Those in the third group (44%) were concerned about BZD prescribing and found it to be a "bad solution," but were faced with various barriers to applying nonpharmacologic approaches. Surprisingly, we found that nearly 97% of FPs thought that most people were eligible for nonpharmacologic approaches, but experienced implementation barriers at the level of the patient, the level of the FP, and the level of the health care system.

Conclusion: Using different education and behavioural-change strategies for different FP groups seems important. A large group of FPs does not find prescribing BZDs to be problematic. Sensitizing and alerting FPs to this issue remains very important.