Does tailoring really make a difference? : the development and evaluation of tailored interventions aimed at benzodiazepine cessation

Abstract

Because of the problems associated with chronic benzodiazepine use, there is impetus to prevent and reduce chronic benzodiazepine use. The overall aim was to develop a 'tailor-made' intervention in order to reduce chronic use. Before developing tailored patient education, it is first of all important to know which psychosocial factors predict benzodiazepine cessation. The computer-tailored intervention should target and change these determinants. The thesis showed that benzodiazepine users had a greater intention to quit and were more likely to quit their benzodiazepine intake if they perceived many positive consequences of cessation, while at the same time perceiving few negative consequences. In addition, higher self-efficacy was associated with cessation. These determinants were translated into intervention texts on the computer. The computer programme produced single-tailored letters and multiple-tailored letters. Single-tailored letters consisted of one letter of advice and multiple-tailored letters consisted of three different letters with a one-month interval. The multiple-tailored letters took into account the changes in benzodiazepine use over time. The results showed that tailored letters were twice as effective as non-tailored letters in quitting benzodiazepine use, especially in the case of patients who were already intending to quit. We found, however, no differences between single and multiple-tailored letters.