Big Bird: Effizienz eines gemischten Behandlungsprogramms zur Reduzierung der Benzodiazepin-Einnahme bei Schlafstörungen in der Primärversorgung: eine randomisierte Cluster-Studie (KCE-17016)

This project measured whether blended care (having access to an online platform with information, advice and support in addition to the face-to-face treatment provided by the family doctor) is more effective than usual care, i.e. standard treatment (only face-to-face treatment provided by the family doctor), for discontinuing long-term use of sleep medication (benzodiazepines or z-drugs) in primary care. Blended care differed from usual care by offering general practitioners and patients the opportunity to work with an interactive e-learning program. This program was based on cognitive behavioral therapy for insomnia (CBTi), which is a psychotherapeutic approach to treating insomnia. The study compared blended and usual care in a real-world setting, being in the general practitioners’ surgery. General practitioners, and via them their patients, were placed in one of two groups, resulting in having access or not to the interactive e-learning program. Treatment success was determined by the number of patients having stopped their sleep medication use at one year after the start of their discontinuation treatment.

Patients using sleep medication for at least six months on a daily basis could enter the study. Between May 23 and December 20, 2019, 1814 individuals were screened for participation, of which 50% qualified and were willing to participate. 99 GPs were assigned by chance to provide one of the two treatments to all of their patients, which globally represented the 916 patients included.

Whether patients managed to stop taking their sleep medication was assessed by asking the patients and general practitioners, and by testing if these drugs were present in a urine sample provided by the patient. Patients were followed for one year, during which three urine samples were collected. Urine sample results from the sample at 1 year were obtained from 727 individuals (79%).

In both groups, some patients stopped taking their sleep medication. Almost 1 in 5 (19%) of people in the study stopped taking sleep medication after one year (18% in the e-learning program group and 20% in the routine care group). Having access to the interactive e-learning program did not mean that more individuals stopped taking their sleeping medication than in the group with only routine care from their GP. Interviews showed that motivation, but also advice and follow-up by the doctor were important for stopping sleep medication.

More details about the study can be found in the clinical report, via the link to the right, once the study has been published. Or in the publication, also available via the link to the right.

People who participated in the study will receive a summary of the results directly from their family doctor.