Benzodiazepine e-health Program

Transcription

1 Evolution: Innovation and reflection in Victoria s alcohol and other drug sector Benzodiazepine e-health Program Presented by Janet Shaw Manager, Reconnexion a service of EACH

2 Benzodiazepine (BZD) e-health Program Accessible, online information and reduction program for people using benzodiazepines Designed and developed by Federation University in consultation with Reconnexion a service of EACH To be evaluated in an open trial

3 Principal Researcher: Professor Britt Klein Personal Chair in Psychology and ehealth, Federation University Other Researchers: Janet Shaw, Manager, Reconnexion Janet Haynes, Programs & Operations Coord, Reconnexion A/Prof Peter Schattner, Dept of General Practice, Monash University Professor Sue McLaren, Head of Psychology, Federation University Sue Lauder, Research Associate, Federation University Jordi Llonch, Director, Nitidum P/L Technical consultant

4 What is this project about?

5 BZD e-health Program: Why do we need it? 7 mil + Australian BDZ prescriptions 1 every year Long-term BDZ use risk and burden (poor health, pain, side effects, dependency) 2-5 Population impact (socioeconomic) Lack of BDZ resources and supports Barriers to seeking direct help 7

6 BDZ e-health Program genesis E-Health interventions: - overcome traditional barriers - are established for many other conditions - have not been trialled for the support of BDZ users Panic Online BDZ modules indicate reductions or abstinence of 11% to 57%

7 Participant Requirements Over 18 and living in Australia Consent to participate in the study Complete: five screening questions pre-monitoring questionnaire weekly questions and two questionnaires week 3 post intervention questionnaires week 6 3 month follow up questionnaire weeks 10 and 18 Participants can withdraw at any time

8 BDZ ehealth Program design Introduction Module and five core modules Module One: Benzodiazepines and Dependence Psycho-education about what BDZs are dependency on BDZ BDZ effectiveness appropriate and inappropriate uses of BDZ.

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10 BDZ ehealth Program design Module Two: The Pathway to Reduction The 3 main steps in the BDZ reduction process Module Three: A Gradual Reduction Program (Case Illustration) Peter s gradual benzodiazepine reduction program Module Four: Withdrawal Symptoms Common and uncommon BDZ withdrawal symptoms and the issues with going cold turkey

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12 BDZ ehealth Program design Module Five: Managing Withdrawal Symptoms Information and strategies to help manage the reduction/withdrawal symptoms, including controlled breathing progressive muscle relaxation mindfulness meditation problem solving goal setting increasing physical exercise nutrition sleep hygiene

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15 What else? On the go tools Audio: Controlled breathing exercises Progressive muscle relaxation Mindfulness meditation Video: Problem solving What to expect Helpful hints Information and downloadable worksheets: Goal setting Nutrition Exercise Sleep hygiene

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17 Target: the general community Recruitment Advertisements: Reconnexion website, Reconnexion Face Book page, Reconnexion newsletter, Fed News, other professional and community websites, local and community newspapers Flyers: Federation University, cafes, libraries, community centres Direct: Reconnexion specialist BDZ counsellors and support line s: global distribution lists, general practices Interested people will be directed to both the Reconnexion and BDZ ehealth websites for more information

18 References 1. Royal Australian College of Physicians (RACP) (2013). Submission to the Therapeutic Goods Administration (TGA) Advisory Committee on Medicines Scheduling. B8DB-550C-61FC1612B21C1C55 2. Stewart, S.A. (2005). The effects of benzodiazepines on cognition. Journal of Clinical Psychiatry, 66(2), Lader, M. (2011). Benzodiazepines revisited - Will we ever learn? Addiction, 106(12), Ashton, H. (2005). The diagnosis and management of benzodiazepine dependence. Current Opinion in Psychiatry, 18(3), Authier, N., Balayssaca, D., Sautereauc, M., Zangarellia, A., Courtyc, P., Somogyid, A.A., Vennate, B., Llorcac, P-M., & Eschalierb, A. (2009). Benzodiazepine dependence: Focus on withdrawal syndrome. Annales Pharmaceutiques Françaises, 67(6), Klein, B. (2010). e-interventions and psychology: Time to log on!. InPsych, 31, Christensen, H., Batterham, P., & Calear, A. (2013). Online interventions for anxiety disorders. Current Opinions in Psychiatry, 27, Andrews G, Cuijpers P, Craske MG, et al. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical healthcare: a metaanalysis. PLoS One 2010; 5:e Griffiths KM, Farrer L, Christensen H. The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. Med J Aust 2010; 192:S4 S Beintner I, Jacobi C, Taylor CB (2012). Effects of an internet-based prevention programme for eating disorders in the USA and Germany: a meta-analytic review. European Eating Disorders Review 20, Tait RJ, Christensen H (2010). Internet-based interventions for young people with problematic substance use: a systematic review. Medical Journal of Australia 192, S White, A., Kavanagh, D, Stallman, H., Klein, B., Kay-Lambkin, F., Proudfoot, J., Drennan, J., Connor, J., Young, R., Baker, A., & Hines, E. (2010). Online alcohol interventions: A systematic review. Journal of Medical Internet Research. 12, e Wootten, A., Abbott, J., Chisholm, K., Meyer, D., Austin, D., Klein, B., McCabe, M., Costello, T., & Murphy, D. (accepted). Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer. European Urology 14. Klein, B & Richards, J.C. (2001). A brief internet-based treatment for panic disorder. Behavioural and CognitivePsychotherapy, 29, Klein, B., Richards, J.C. & Austin, D.W. (2006). Efficacy of internet therapy for panic disorder. Journal of Behavior Therapy and Experimental Psychiatry. 37(3), Richards, J.C., Klein, B., & Austin, D.W. (2006). Internet CBT for panic disorder: Does the inclusion of stress management information improve end-state functioning? Clinical Psychologist, 10; Klein B., Austin, D., Pier, C., Kiropoulos, L., Shandley, K., Mitchell, J., Gilson, K., Ciechomski, L. (2009). Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference? Cognitive Behaviour Therapy 28(2), Shandley, K., Austin, D., Klein, B., Pier, C., Schattner, P., Pearce, D., & Wade, T. (2008). Therapist-assisted, internet-based treatment for panic disorder: Can general practitioners achieve comparable patient outcomes to psychologists? Journal of Medical Internet Research, 10, e Kiropoulos, L.A., Klein, B., Austin, D.W., Gilson, K. Pier, C., Mitchell, J., Ciechomski, L. (2008). Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders, 22(8), Klein, B., Shandley, K., Austin, D., & Nordin, S. (2008). Pilot trial of Panic Online self-guided version: Internetbased treatment for panic disorder. ejournal of Applied Psychology, 4 (2), Pier, C, Austin, D.W., Klein, B., Mitchell, J., Schattner, P., Ciechomski, L., Gilson, K., Pierce, D., Shandley, K., & Wade, T. (2008). Evaluation of internet-based cognitive behavioural therapy for panic disorder in general medical practice. Mental Health in Family Medicine, 5,