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.

研究目的：本研究旨在为考虑逐步减量苯二氮䓬类（benzodiazepine, BZD）抗焦虑药物的焦虑障碍患者开发一款决策辅助工具（decision aid, DA），并针对减量BZD抗焦虑药物时联合或不联合认知行为疗法（cognitive behavioral therapy, CBT）的方案进行适配设计。同时本研究还评估了该工具在各类利益相关者中的可接受性。
研究方法：首先，针对焦虑障碍开展文献综述以明确治疗方案，引用本团队此前完成的系统综述与荟萃分析结果，阐述两种核心方案的相关结局：联合CBT的BZD抗焦虑药物减量方案，以及不联合CBT的BZD抗焦虑药物减量方案。其次，依据《国际患者决策辅助标准》（International Patient Decision Aid Standards）开发了决策辅助工具原型，并采用混合方法调研，评估包括焦虑障碍患者与医疗服务提供者在内的利益相关者对该工具的可接受性。
研究结果：本决策辅助工具涵盖以下内容：焦虑障碍的相关释义、针对焦虑障碍患者的BZD抗焦虑药物是否减量的选择方案（若选择减量，则包含联合或不联合CBT的减量方案）、各方案的获益与风险，以及用于价值澄清的工作表。在21名患者受访者中，86%的参与者认为该工具的语言适配性良好，81%认为其信息充分，86%认为其内容呈现平衡。针对10名医疗服务提供者的调研结果同样显示该工具具备良好可接受性。
研究结论：本研究成功开发了一款面向考虑逐步减量BZD抗焦虑药物的焦虑障碍患者的决策辅助工具，且该工具同时获得了患者与医疗服务提供者的认可。本工具旨在协助患者与医疗服务提供者共同参与关于是否减量BZD抗焦虑药物的决策制定。