Table 2 Main domains identified in the reviews regarding the practices and perceptions of other health professionals

Anderson (2014) [23]

Awareness: level of insight a prescriber has into the appropriateness of his/her prescribing.

Inertia: failure to act despite awareness that prescribing is potentially inappropriate. This was due to the perception that ceasing PIMs was a less appealing proposition than continuing PIMs.

Self-Efficacy: factors that influence a prescriber’s belief and confidence in his or her ability to address PIM use, involving knowledge, skills, attitudes, influencers, information and support for decision making.

Feasibility: factors that are external to the prescriber and determine the ease or likelihood of change. They relate to patient characteristics, resource availability, work practices, medical and societal health beliefs and culture, and regulations.

Sirdfield (2013) [22]

The changing context of benzodiacepines prescribing: norms of practice, evidence, guidance, introduction of new drugs and services, legal regulatory frameworks and societal attitudes around the treatment of conditions.

Role and responsibility of general practice: Balance between responsibility over historical prescribing practices (help patient) and the responsibility to minimize benzodiacepine use.

The ‘deserving’ patient: GPs often managed the tension between minimizing prescribing and their responsibility to help patients on a case-by-case basis. They needed to justify giving or withholding benzodiazepines, expressed in the literature through the concept of the ‘deserving patient.

Perceived patient expectations Prescribing was influenced by how doctors perceived patients’ expectations, motivations and ability to cope.

GP attitudes towards different interventions Treatment choices of GPs in response to their perceptions of their patients, their patients’ expectations, and their own role and responsibilities were further influenced by their own attitudes and beliefs about different interventions.

Different challenges for managing initiation and withdrawal GPs’ view of their role, perceived risks and effectiveness of benzodiazepines or alternative treatments, and the patient all influenced whether or not a GP chose to initiate, continue or withdraw benzodiazepines.

Ambivalent attitudes towards prescribing benzodiazepines leading to inconsistent strategies for managing prescribing This attitude ranged from those who rarely prescribed, to those who did not see a problem with prescribing benzodiazepines. For most GPs, located in the middle of this continuum, these were complex decisions leading to conflicting pressures about whether or not to prescribe.