Feasibility of a benzodiazepine deprescribing program to reduce side effects and carbon emissions

While many health systems are trying to develop an actionable roadmap towards a net-zero health system, medications have been identified as one of the largest contributors to carbon emissions. The idea of “sober” prescribing patterns is thus emerging, yet remains as an umbrella term without concrete evidence or programs on the policy agenda.

 

At the same time, this idea has a natural link to a well-identified public health problem:  polypharmacy, or the prescription of 5 or more drugs. This problem is increasingly prevalent and poses serious threats in terms of side effects via drug interactions. It has become a particular public and mental health concern with the recent surge of psychotropic prescriptions since the Covid-19 pandemic, related to the rising prevalence of anxiety and depression. Indeed, health professionals are generally trained at prescribing, but not at de-prescribing. The latter has now emerged as a dedicated field of study.

 

Our study, addressing two of the four main topics of focus in this year’s conference (health system and interdisciplinary approaches to quality; new frontiers for research and policy), will combine these two streams and addresses the following questions:

• What does the literature say about deprescribing programs that work?


• What is the estimated impact (clinical, economic and carbon) of deprescribing benzodiazepines?


• What are barriers and facilitators, with providers and patients, for a benzodiazepine deprescribing pilot program in France?  


• Would including carbon footprint as a rationale have an effect on the acceptability of such a program?  

 

To this end, we will collect data via internet databases and conduct semi-structured interviews with stakeholders, practitioners and patients. After analysis of the evidence, we will assess feasibility and attempt the design of an actionable pilot program.