AUTHOR=Aoki Yumi , Takaesu Yoshikazu , Inada Ken , Yamada Hiroki , Murao Tomohiko , Kikuchi Toshiaki , Takeshima Masahiro , Tani Masayuki , Mishima Kazuo , Otsubo Tempei 

TITLE=Development and acceptability of a decision aid for anxiety disorder considering discontinuation of benzodiazepine anxiolytic

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1083568

DOI=10.3389/fpsyt.2023.1083568

ISSN=1664-0640

ABSTRACT=Aim
To describe the development and acceptability of a decision aid (DA) for anxiety disorders considering discontinuation of benzodiazepine (BZD) anxiolytics, and if discontinuing, tapering with or without cognitive behavioral therapy (CBT) for anxiety.
Methods
We reviewed relevant literature describing anxiety disorders to identify treatment options. We also used the results of the systematic review and meta-analysis conducted previously to determine the related outcomes of two options: discontinuation of BZD anxiolytics by gradual tapering alone and discontinuation of BZD anxiolytics by gradual tapering with CBT. We then developed a prototype of DA following the International Patient Decision Aid Standards. A mixed methods survey was conducted to assess the acceptability among patients and healthcare providers.
Results
The prototype consisted of a description of anxiety disorders, options of continuing or discontinuing BZD anxiolytics (if discontinuing, the options of tapering anxiolytics with or without CBT), pros and cons of each option, and a value clarification exercise. Patients (n = 21) reported that the DA had acceptable language (86%), adequate information (81%), and well-balanced presentation (86%). Healthcare providers (n = 10) also provided favorable feedback.
Conclusion
We successfully developed a DA for anxiety disorders considering discontinuation of BZD anxiolytics, which was acceptable for stakeholders. The developed DA was designed to support patients and healthcare providers to make a decision together about whether to discontinue BZD anxiolytics.