Exploring barriers, strategies, and evaluation approaches for implementing benzodiazepine deprescribing in European older adults

Shapoval, Vladyslav
(2026)

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Authors
Supervisors
Spinewine, Anne  
 ;
Henrard, Séverine  
Abstract
Benzodiazepines and related drugs (BZRAs) are frequently prescribed to treat sleep disorders. However, their use beyond four weeks poses more risks than benefits, particularly among people 65 years and older. Consequently, evidence-based recommendations have been developed to limit their long-term use. Despite these recommendations, deprescribing remains difficult to implement, and BZRA use remains high in Europe. This doctoral thesis aims to improve the implementation of BZRA deprescribing recommendations in Europe by drawing on implementation science. It first describes the behavioural barriers encountered by physicians, other healthcare professionals, and patients based on quantitative surveys conducted in six European countries. It then analyses the implementation strategies by evaluating clinical trials of BZRA deprescribing, their alignment with the identified barriers, and their implementation outcomes. Finally, it contributes to the design of the process evaluation for a cluster-randomised controlled trial assessing the implementation of a new BZRA deprescribing intervention through behavioural changes and implementation outcomes among physicians and patients. The findings highlight key implementation gaps and provide practical insights on how to improve the uptake of BZRA deprescribing in clinical practice.
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Shapoval, V. (2026). Exploring barriers, strategies, and evaluation approaches for implementing benzodiazepine deprescribing in European older adults. https://hdl.handle.net/2078.5/279772