UOC and BSA launch groundbreaking project to reduce overuse of sleeping pills and anxiety medication

The widespread use of benzodiazepines – better known as sleeping pills or anxiety medication – among the population has become a serious public health issue. These psychotropic drugs, central nervous system depressants prescribed to treat anxiety and insomnia, carry a high risk of dependence, cognitive impairment and falls, among other consequences. A 2024 study carried out by the Spanish Organization of Consumers and Users (OCU) showed that 22% of the Spanish population regularly use this type of medication, in four out of ten cases on a daily basis. 

The overprescription of benzodiazepines, especially in primary care settings, is thought to be one of the main factors behind this overuse, and health organizations are working to help health practitioners change this prescribing pattern. The Universitat Oberta de Catalunya (UOC) has developed a project together with Badalona Serveis Assistencials (BSA) to reduce the number of long-term benzodiazepine users. The intervention, which is aimed at both healthcare practitioners and patients, incorporates behavioural theoretical frameworks, an area in which the UOC is internationally renowned.

Manuel Armayones, a holder of a PhD in Psychology and full professor of behavioural design, leads the BDLab (Behavioural Design Lab) group, which has teamed up with BSA on the No et quedis atrapat (Don't get stuck) project to help discontinue the use of these drugs or prevent their initiation in the first place. "The causes of these practices include factors relating to healthcare settings themselves, such as short appointments and overworked practitioners. Practitioners sometimes may feel that benzodiazepines are the only available tool to relieve patients' discomfort. There's also an understandable fear on the part of both healthcare practitioners and patients that symptoms will get worse if the medication is withdrawn, especially in cases of physical and psychological dependence," said Armayones.

"This project allows us to advance towards safer, more person-centered care. We work to reduce risks for citizens, but also to offer professionals who facilitate more informed and coherent clinical decisions," says Àlex Escosa Farga, head of the Primary Care Service at BSA.

Behavioural design to help patients and practitioners break the habit

As a result of the research carried out by BDLab, a group attached to the UOC's eHealth Centre, a proof of concept aimed at helping to reduce the prescription of benzodiazepines will be carried out from this March at the CAP Martí i Julià primary care centre in Badalona. This is the third phase of a project carried out by the UOC and BSA with funding from the Spanish Ministry of Science and Innovation. The project, designed using behavioural design and co-creation techniques with healthcare professionals, is now entering the implementation stage to encourage a reduction in both the use and prescription of these medicines. 

The first part of the project, led by the UOC researchers, involved a systematic review of interventions to reduce the prescription of benzodiazepines in primary care settings. The study concluded that multi-dimensional interventions, which include a variety of actions such as patient education and pharmacist involvement, are the most effective approach. The research led to the publication of the article "De-implementing inappropriate benzodiazepine prescribing in primary care:an overview of systematic reviews informed by behavioral frameworks" (Implementation Science Communications, February 2026), which states that interventions with behavioural design components are more effective and sustained over time. 

"We're aiming to change not just the volume of drugs prescribed, specifically benzodiazepines, but also deep-rooted patterns of prescription, dispensing and use," said Armayones. "Research shows that the most effective interventions are those that combine clear information about the risks involved, changes in the environment, support in decision-making and opportunities for dialogue. Using theoretical frameworks enables us to choose and combine these elements in a coherent way rather than through trial and error." 

Tools to avoid getting 'stuck'

For three months starting this April, various actions will be carried out at the CAP Martí i Julià primary care centre as part of the 'Don't get stuck' campaign. There will be practical sessions in which professionals will be able to ask questions and share experiences, and they will be given scripts to help them discuss the deprescribing process with patients, guides on alternatives to benzodiazepines and tools to change the prescription and medication review processes.

Patients will be given support materials designed by the Catalan Ministry of Health explaining in plain language the risks associated with the long-term use of this medication and offering sleep hygiene and anxiety management recommendations. In addition, posters will be displayed to encourage patients and healthcare practitioners to discuss the need to progressively reduce these drugs, and community resources and non-pharmacological alternatives to treatment will be put in place.

Reminders will also be added to patients' medical records to review any treatment with benzodiazepines after four weeks. "We're confident that this project will reduce the number of patients using benzodiazepines on a long-term basis and lead to fewer unnecessary prescriptions. We also hope that professionals will feel more in control and better supported when it comes to broaching this issue with patients," said Dr Armayones, who is also a member of the Faculty of Psychology and Education Sciences.

An action with potential applications in all primary care settings

Once it has been completed, the intervention will be assessed from quantitative and qualitative points of view to establish whether it has led to a reduction in prescriptions. If the conclusion is positive, the model will be scaled up and tailored to other BSA-run primary care centres, and the experience will be shared with primary care organizations wishing to address deprescribing "in a structured way tailored to the circumstances of each team," said the researcher. 

This is the first joint action between BDLab and BSA, carried out under the collaboration agreement concluded between them. It is aligned with projects such as the Essencial initiative of the Agency for Health Quality and Assessment of Catalonia (AQuAS) and international initiatives, such as Choosing Wisely,aimed at reducing practices of low clinical value and fostering the continuous improvement of health systems. 

According to Manuel Armayones, "combining BSA's clinical practice with the UOC's behavioural design and applied research makes it possible to effectively address the shared concern of benzodiazepine overuse through interventions that are concrete, assessable and, above all, designed with and for professionals." 

This research by the UOC, which falls under its Digital health and planetary well-being research mission, is part of the project "Behavioural design for low-value clinical practices: improving health care through evidence for behavioural change (Bd4CA)", funded by the Spanish Ministry of Science and Innovation, and supports UN Sustainable Development Goal 3, Good Health and Well-being.

Reference article
Duarte-Anselmi, G., Fernández, M.P., Gómez-Zúñiga, B. et al.De-implementing inappropriate benzodiazepine prescribing in primary care: an overview of systematic reviews informed by behavioral frameworks. Implement Sci Commun (2026). https://doi.org/10.1186/s43058-026-00879-1

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