“At the time I only wanted to relieve stress”: Exploring motivation for behaviour change in long-term hypnotic users
Motivating patients to discontinue long-term benzodiazepine receptor agonist (BZRA) use for insomnia remains an important challenge in primary care because of the medication's unfavourable risk-benefit profile. Previous studies have shown that understanding the complexity of patients' moti...
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| Published in: | Heliyon 2023-05, Vol.9 (5), p.e16215-e16215, Article e16215 |
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| Main Authors: | , , , , |
| Format: | Article |
| Language: | eng |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Motivating patients to discontinue long-term benzodiazepine receptor agonist (BZRA) use for insomnia remains an important challenge in primary care because of the medication's unfavourable risk-benefit profile. Previous studies have shown that understanding the complexity of patients' motivation is crucial to the primary care physician for providing effective interventions efficiently. Theoretical frameworks about behaviour change show that motivation is a multi-layered concept that interacts with other concepts, which aligns with a holistic perspective or implementation of the biopsychosocial model.
Exploring primary care patients’ views and ideas on what factors helped or hindered them in discontinuing long-term BZRA use, in relation to motivation as conceptualised in the Behaviour Change Wheel, and associated domains of the Theoretical Domains Framework.
A qualitative study with semi-structured interviews in primary care in Belgium between September 2020 and March 2021.
Eighteen interviews with long-term hypnotic users were audio recorded, transcribed and thematically analyzed, using the Framework Method.
The success of discontinuation interventions does not solely rely on patients’ spontaneous sense of striving for improvement. Reinforcement and identity were found to be important domains for motivation. Beliefs about personal capabilities, and about consequences of both BZRA intake and discontinuation, differed between previous and current users.
Motivation is a multi-layered concept which is not fixed in time. Patient empowerment and goal setting could help long-term BZRA users to lower their intake. As well as public health interventions that might change social attitudes towards the use of hypnotic medication.
•The biomedical model is still predominant in the management of insomnia.•Motivation changes over time. Regular re-examination is key to patient-centredness.•‘Reinforcement’ and ‘identity’ (TDF) were most represented in patients' narratives.•Patients' intentions and beliefs about consequences help assess motivation.•Changed social attitudes will likely improve patients' beliefs about capabilities. |
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| ISSN: | 2405-8440 2405-8440 |