Research article

Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand

Manit Srisurapanont^1*, Paul Garner², Julia Critchley² and Nahathai Wongpakaran¹

• * Corresponding author: Manit Srisurapanont msrisura@mail.med.cmu.ac.th

Author Affiliations

¹ Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Amphur Muang, Chiang Mai, 50200 Thailand

² International Health Research Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA UK

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BMC Family Practice 2005, 6:27 doi:10.1186/1471-2296-6-27

Published: 23 June 2005

Abstract

Background

Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand.

Methods

Questionnaire survey of general practitioners in community hospitals, to estimate: i) use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii) views on the optimal duration of benzodiazepine use.

Results

Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%), panic disorder (n = 43, 78%), depression (n = 26, 43%), essential hypertension (n = 15, 27 %) and uncomplicated low back pain (n = 10, 18%). Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%); or from 1 week to 1 month (47%); or 1 to 4 months (16%); or 4 to 6 months (5%) or more than 6 months (2%). Twenty-five general practitioners (45%) accepted that they used benzodiazepines excessively in the past year.

Conclusion

A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.