Data_Sheet_2_Development and acceptability of a decision aid for anxiety disorder considering discontinuation of benzodiazepine anxiolytic.PDF

AimWe aimed to develop a decision aid (DA) for individuals with anxiety disorders who consider tapering benzodiazepine (BZD) anxiolytics, and if tapering, tapering BZD anxiolytics with or without cognitive behavioral therapy (CBT) for anxiety. We also assessed its acceptability among stakeholders.MethodsFirst, we conducted a literature review regarding anxiety disorders to determine treatment options. We cited the results of the systematic review and meta-analysis, which we conducted previously, to describe the related outcomes of two options: tapering BZD anxiolytics with CBT and tapering BZD anxiolytics without CBT. Second, we developed a DA prototype in accordance with the International Patient Decision Aid Standards. We carried out a mixed methods survey to assess the acceptability among stakeholders including those with anxiety disorders and healthcare providers.ResultsOur DA provided information such as explanation of anxiety disorders, options of tapering or not tapering BZD anxiolytics (if tapering, the options of tapering BZD anxiolytics with or without CBT) for anxiety disorder, benefits and risks of each option, and a worksheet for value clarification. For patients (n = 21), the DA appeared to be acceptable language (86%), adequate information (81%), and well-balanced presentation (86%). The developed DA was also acceptable for healthcare providers (n = 10).ConclusionWe successfully created a DA for individuals with anxiety disorders who consider tapering BZD anxiolytics, which was acceptable for both patients and healthcare providers. Our DA was designed to assist patients and healthcare providers to involve decision-making about whether to taper BZD anxiolytics or not.

本研究旨在为考虑减量使用苯二氮卓类抗焦虑药（BZD）的焦虑症患者开发决策辅助工具（DA），并评估其在采用认知行为疗法（CBT）或未采用CBT的情况下减量使用BZD抗焦虑药的可行性。此外，我们还对利益相关者（包括焦虑症患者和医疗保健提供者）对该决策辅助工具的接受度进行了评估。方法方面，首先，我们对焦虑症相关文献进行了综述，以确定治疗方案。我们引用了先前进行的系统评价和荟萃分析的结果，以描述两种选择的相关结局：在CBT辅助下减量使用BZD抗焦虑药以及未采用CBT的减量使用BZD抗焦虑药。其次，我们根据国际患者决策辅助工具标准开发了决策辅助工具的原型。我们进行了一项混合方法调查，以评估包括焦虑症患者和医疗保健提供者在内的利益相关者的接受度。结果方面，我们的决策辅助工具提供了关于焦虑症的解释、减量或不减量使用BZD抗焦虑药（若减量，包括是否在CBT辅助下减量使用BZD抗焦虑药）的选项、每种选项的利弊以及价值澄清工作表等信息。对于患者（n=21），决策辅助工具在语言表达（86%）、信息充分性（81%）以及平衡性呈现（86%）方面均得到了较好的接受。所开发的决策辅助工具也获得了医疗保健提供者（n=10）的接受。结论方面，我们成功地为考虑减量使用BZD抗焦虑药的焦虑症患者开发了一款决策辅助工具，该工具既被患者也被医疗保健提供者接受。我们的决策辅助工具旨在协助患者和医疗保健提供者在是否减量使用BZD抗焦虑药的问题上进行决策。