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At the heart of general practice since 1960

CBT can help GPs curb use of benzodiazepines

GPs could help one in three long-term users come off benzodiazepines if practice-based cognitive behaviour therapy was more widely available, a Government-commissioned

study suggests.

The health technology assessment on psychological treatment for insomnia found that six months after receiving the therapy, 33 per cent of patients with chronic sleep problems were no longer using hypnotic drugs.

But the RCGP said the potential benefits of CBT in general practice may not be realised because of a lack of

resources.

GPs were ordered last month to step up their efforts to wean long-term users off benzodiazepines.

Chief Medical Officer Professor Sir Liam Donaldson said 30 per cent of scripts were for 56 or more tablets in 2002, suggesting too many patients were using long-term treatment.

The new assessment, carried out by researchers at the Loughborough Sleep Research Centre, involved a study in 23 general practices showing that CBT for in-

somnia could be effectively

delivered in a GP surgery

setting.

The cost of the treatment was good value at £154 per patient for service provision and £3,418 per quality-adjusted life-year at six months, the researchers concluded.

The patients in the study had been receiving repeat prescriptions for hypnotics for an average of 13 years. Primary care counsellors conducted six 50-minute sessions covering sleep hygiene, relaxation and cognitive therapy, with consultant clinical psychologists pro- viding fortnightly supervision.

The patients receiving psychological treatment had

better-quality sleep, physical functioning and mental health.

The researchers said psychological intervention could help GPs meet milestones in the NSF for older people, which recommends proactive steps to get patients to come off long-term hypnotics.

RCGP mental health spok-esperson Dr Alan Cohen, a GP in London, said the study findings were 'eminently logical'.

But he added: 'There is an even greater shortage of CBT therapists than there is of

counsellors.'

By Cato Pedder

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