989fc5cbfae3cec8f4e0313084206c76 327823.pdf 56d981adca84b36a210c6483a4879b527628dab8 327823.pdf 6b919f51857850c77761ada8f602250bf4ef21af69490797a4d1b1166258bc39 327823.pdf Title: Barriers to discontinuing benzodiazepine receptor agonists in older adults: a survey of older adults across Europe Subject: AcademicSubjects/MED00280, DOI: 10.1093/ageing/afaf342, Age and Ageing, 54, 00, 25 11 2025. Abstract: Background: Various factors hinder older adults from discontinuing benzodiazepine receptor agonists (BZRAs). Identifying and prioritising these barriers is essential for designing effective interventions to discontinue BZRAs. Objective: To identify barriers to BZRA discontinuation among older adults and factors associated with their willingness to reduce or stop use. Methods: A cross-sectional survey was conducted among adults 65+ using BZRA for sleep problems, recruited from hospitals across six European countries. Barriers were identified via a 27-item questionnaire grounded in the Theoretical Domains Framework (TDF), which systematically identifies individual and contextual determinants of behaviour. Responses were analysed using descriptive statistics. Multivariable logistic regressions identified factors associated with patients’ willingness to reduce or stop BZRA. Results: Among 183 participants, 59.1% were willing to reduce and 42.7% to stop BZRA if recommended by their doctor. Half understood why discontinuation is necessary. Barriers were present for most participants across multiple TDF domains. They included: high satisfaction with BZRA, perceived low risk of side effects, limited coping skills or ability to stop, fear of discontinuation and lack of support from physicians or social networks. Higher scores in the TDF domains of Goals, Emotion and Social Influences were associated with greater willingness to reduce BZRA. These domains and Reinforcement, Environmental context and resources were also linked to a greater willingness to stop. Conclusions: These findings highlight the opportunities and challenges of discontinuing BZRA in older adults. While half know the need to discontinue and are willing to try, future interventions must address pervasive barriers across many behavioural domains. Keywords: Author: Creator: LaTeX with hyperref package Producer: Acrobat Distiller 23.0 (Windows) CreationDate: Sat Nov 29 11:30:26 2025 CET ModDate: Sat Nov 29 11:30:26 2025 CET Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 612.332 x 790.759 pts Page rot: 0 File size: 1024345 bytes Optimized: yes PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CFNHEH+GillSansStd-Bold Type 1C Custom yes yes yes 2400 0 CFNHFH+GillSansStd-LightItalic Type 1C Custom yes yes yes 2401 0 CFNHFI+GillSansStd-Light Type 1C Custom yes yes yes 2402 0 CFNHGJ+AGaramondPro-Regular Type 1C Custom yes yes yes 2403 0 CFNHHJ+GillSansMTStd-Light Type 1C Custom yes yes yes 2303 0 CFNJKN+AGaramondPro-Bold Type 1C Custom yes yes yes 2404 0 CFNJMN+MTSYN Type 1C Custom yes yes yes 2405 0 CFNJON+GillSansStd-BoldItalic Type 1C Custom yes yes yes 36 0 CFNLLF+MTMI Type 1C Custom yes yes yes 37 0 CFNLPE+GillSansStd Type 1C Custom yes yes yes 38 0 CFNMAF+AGaramondPro-BoldItalic Type 1C Custom yes yes yes 39 0 CFNLKE+AGaramondPro-Italic Type 1C Custom yes yes yes 40 0 CFOHBC+MSAM7 Type 1C Custom yes yes no 29 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-04-22 04:05:24 CEST RepresentationInformation: 327823.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-04-21 08:37:46 CEST Size: 1024345 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: Linearized PDF, Tagged PDF PDFMetadata: Objects: 2442 FreeObjects: 1 IncrementalUpdates: 1 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: true NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseOutlines Language: en Outlines: Item: Title: Barriers to discontinuing benzodiazepine receptor agonists in older adults: a survey of older adults across Europe Destination: toc.chapter Children: Item: Title: Introduction Destination: section.32.1.1 Item: Title: Methods Destination: section.33.1.2 Item: Title: Results Destination: section.41.1.3 Item: Title: Discussion Destination: section.51.1.4 Item: Title: Conclusion Destination: section.54.1.5 Item: Title: 6 Acknowledgements: Destination: section.55.1.6 Item: Title: 7 Supplementary Data: Destination: section.56.1.7 Item: Title: 8 Declaration of Conflicts of Interest: Destination: section.57.1.8 Item: Title: 9 Declaration of Sources of Funding: Destination: section.58.1.9 Item: Title: 10 Data Availability: Destination: section.59.1.10 Info: Title: Barriers to discontinuing benzodiazepine receptor agonists in older adults: a survey of older adults across Europe Author: Subject: AcademicSubjects/MED00280, DOI: 10.1093/ageing/afaf342, Age and Ageing, 54, 00, 25 11 2025. Abstract: Background: Various factors hinder older adults from discontinuing benzodiazepine receptor agonists (BZRAs). Identifying and prioritising these barriers is essential for designing effective interventions to discontinue BZRAs. Objective: To identify barriers to BZRA discontinuation among older adults and factors associated with their willingness to reduce or stop use. Methods: A cross-sectional survey was conducted among adults 65+ using BZRA for sleep problems, recruited from hospitals across six European countries. Barriers were identified via a 27-item questionnaire grounded in the Theoretical Domains Framework (TDF), which systematically identifies individual and contextual determinants of behaviour. Responses were analysed using descriptive statistics. Multivariable logistic regressions identified factors associated with patients’ willingness to reduce or stop BZRA. Results: Among 183 participants, 59.1% were willing to reduce and 42.7% to stop BZRA if recommended by their doctor. Half understood why discontinuation is necessary. Barriers were present for most participants across multiple TDF domains. They included: high satisfaction with BZRA, perceived low risk of side effects, limited coping skills or ability to stop, fear of discontinuation and lack of support from physicians or social networks. Higher scores in the TDF domains of Goals, Emotion and Social Influences were associated with greater willingness to reduce BZRA. These domains and Reinforcement, Environmental context and resources were also linked to a greater willingness to stop. Conclusions: These findings highlight the opportunities and challenges of discontinuing BZRA in older adults. While half know the need to discontinue and are willing to try, future interventions must address pervasive barriers across many behavioural domains. Keywords: Creator: LaTeX with hyperref package Producer: Acrobat Distiller 23.0 (Windows) CreationDate: Sat Nov 29 12:00:26 CET 2025 ModDate: Sat Nov 29 12:00:26 CET 2025 ID: 0x52da430deb19d0c511908c1698fa4b8b, 0xcb1bae44398ca8e89c3001cccdb665cc Filters: FilterPipeline: FlateDecode FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 2000 ImageHeight: 1668 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1900 ImageHeight: 1230 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Fonts: Type1: Font: BaseFont: CFNHEH+GillSansStd-Bold FontSubset: true FirstChar: 45 LastChar: 122 FontDescriptor: FontName: CFNHEH+GillSansStd-Bold Flags: Symbolic, ForceBold FontBBox: -177, -250, 1167, 929 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNHFH+GillSansStd-LightItalic FontSubset: true FirstChar: 58 LastChar: 121 FontDescriptor: FontName: CFNHFH+GillSansStd-LightItalic Flags: Symbolic, Italic FontBBox: -205, -250, 1051, 894 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNHFI+GillSansStd-Light FontSubset: true FirstChar: 38 LastChar: 243 FontDescriptor: FontName: CFNHFI+GillSansStd-Light Flags: Symbolic FontBBox: -215, -250, 1036, 897 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNHGJ+AGaramondPro-Regular FontSubset: true FirstChar: 2 LastChar: 233 FontDescriptor: FontName: CFNHGJ+AGaramondPro-Regular Flags: Serif, Symbolic FontBBox: -183, -354, 1356, 917 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNJKN+AGaramondPro-Bold FontSubset: true FirstChar: 37 LastChar: 148 FontDescriptor: FontName: CFNJKN+AGaramondPro-Bold Flags: Serif, Symbolic, ForceBold FontBBox: -158, -302, 1147, 899 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNJON+GillSansStd-BoldItalic FontSubset: true FirstChar: 97 LastChar: 116 FontDescriptor: FontName: CFNJON+GillSansStd-BoldItalic Flags: Symbolic, Italic, ForceBold FontBBox: -190, -250, 1074, 915 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNJMN+MTSYN FontSubset: true FirstChar: 2 LastChar: 43 FontDescriptor: FontName: CFNJMN+MTSYN Flags: Symbolic FontBBox: 0, -954, 1043, 900 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNLLF+MTMI FontSubset: true FirstChar: 2 LastChar: 60 FontDescriptor: FontName: CFNLLF+MTMI Flags: Serif, Symbolic, Italic FontBBox: 0, -213, 987, 680 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNLPE+GillSansStd FontSubset: true FirstChar: 46 LastChar: 108 FontDescriptor: FontName: CFNLPE+GillSansStd Flags: Symbolic FontBBox: -162, -250, 1041, 911 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNMAF+AGaramondPro-BoldItalic FontSubset: true FirstChar: 78 LastChar: 110 FontDescriptor: FontName: CFNMAF+AGaramondPro-BoldItalic Flags: Symbolic, Italic, ForceBold FontBBox: -183, -301, 1184, 894 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFNLKE+AGaramondPro-Italic FontSubset: true FirstChar: 45 LastChar: 121 FontDescriptor: FontName: CFNLKE+AGaramondPro-Italic Flags: Serif, Symbolic, Italic FontBBox: -182, -338, 1668, 917 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CFOHBC+MSAM7 FontSubset: true FirstChar: 2 LastChar: 2 FontDescriptor: FontName: CFOHBC+MSAM7 Flags: Symbolic FontBBox: 28, -552, 1490, 1102 FontFile3: true EncodingDictionary: Differences: true Font: BaseFont: CFNHHJ+GillSansMTStd-Light FontSubset: true FirstChar: 2 LastChar: 87 FontDescriptor: FontName: CFNHHJ+GillSansMTStd-Light Flags: Symbolic FontBBox: -215, -232, 1036, 937 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true XMP: application/pdf Barriers to discontinuing benzodiazepine receptor agonists in older adults: a survey of older adults across Europe Shapoval Vladyslavde Saint Hubert MariePétein CatherineViaud ClaireAdda TokandjiAubert Carole ElodieMooser BlandineTsoutsi VagioulaDikeos DimitrisMaldonado Laura FernándezCastejon Joan Manuel PerezWichniak AdamGustavsson KatarzynaWyller Torgeir BruunCallegari EnricoGrimshaw JeremyPresseau JustinPatey AndreaCorachan SabineHenrard SéverineSpinewine Anne AcademicSubjects/MED00280, DOI: 10.1093/ageing/afaf342, Age and Ageing, 54, 00, 25 11 2025. Abstract: Background: Various factors hinder older adults from discontinuing benzodiazepine receptor agonists (BZRAs). Identifying and prioritising these barriers is essential for designing effective interventions to discontinue BZRAs. Objective: To identify barriers to BZRA discontinuation among older adults and factors associated with their willingness to reduce or stop use. Methods: A cross-sectional survey was conducted among adults 65+ using BZRA for sleep problems, recruited from hospitals across six European countries. Barriers were identified via a 27-item questionnaire grounded in the Theoretical Domains Framework (TDF), which systematically identifies individual and contextual determinants of behaviour. Responses were analysed using descriptive statistics. Multivariable logistic regressions identified factors associated with patients’ willingness to reduce or stop BZRA. Results: Among 183 participants, 59.1% were willing to reduce and 42.7% to stop BZRA if recommended by their doctor. Half understood why discontinuation is necessary. Barriers were present for most participants across multiple TDF domains. They included: high satisfaction with BZRA, perceived low risk of side effects, limited coping skills or ability to stop, fear of discontinuation and lack of support from physicians or social networks. Higher scores in the TDF domains of Goals, Emotion and Social Influences were associated with greater willingness to reduce BZRA. These domains and Reinforcement, Environmental context and resources were also linked to a greater willingness to stop. Conclusions: These findings highlight the opportunities and challenges of discontinuing BZRA in older adults. While half know the need to discontinue and are willing to try, future interventions must address pervasive barriers across many behavioural domains. benzodiazepinesz-drugsdeprescribingmedication safetyolder adults © The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. 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