Development of a Women's Empowerment Nurse-Led Group Intervention for Benzodiazepine and Z-Hypnotic Deprescription in Primary Healthcare: Results of a Co-Creation Process.

aimThe aim of this study was to co-create a nurse-led women's empowerment group intervention to facilitate the deprescription of benzodiazepines and Z-hypnotics in primary care.

designUser-centred design based on co-creation.

methodsA literature review was conducted to identify female empowerment programmes that served as an initial prototype. The subsequent user-centred design applied a co-creation methodology in two structured phases: (1) Exploratory, to identify contextual needs and barriers, and (2) Development, to collaboratively define the intervention's final structure and content. Participants included chronic users of benzodiazepines and Z-hypnotics and primary care professionals (doctors, nurses, and pharmacists) who actively engaged in the collaborative design process.

resultsThe Exploratory phase identified structural and clinical deprescribing barriers, and female clients' knowledge gaps. Empowerment was confirmed as a key facilitator. The Development phase prioritised content (self-esteem, self-image, and healthcare) and adjusted the group intervention's format (duration, frequency, and structure) based on participant input.

conclusionThe co-creation process resulted in an eight-session intervention, with support cards and a training video for nurse-facilitators. This collaboration ensured the final design was precisely tailored to women's needs and clinical practice, maximising its feasibility and relevance. The intervention facilitates the tapering of benzodiazepines and Z-hypnotics by combining women's empowerment with individualised and supervised dose reduction by primary care clinicians. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Demonstrates how co-creation with clients and healthcare professionals can lead to contextually adapted nurse-led interventions centred on women's empowerment. Highlights the role of women's empowerment as a catalyst for deprescribing long-term benzodiacepines and Z-hypnotics in primary healthcare. Introduces a structured and co-created eight-session intervention supported by a nurse-training video and support cards, offering practical toolkits. PUBLIC CONTRIBUTION: Clients (as users) and primary care healthcare professionals actively participated in the design of the intervention aimed at empowering women. Their involvement included participation in co-creation workshops, in which needs and everyday realities relevant to the process of deprescribing benzodiazepines and Z-hypnotics were identified. The structure and content of the group intervention, as well as its relevance and feasibility, were defined collaboratively. This direct participation made it possible to develop an intervention that was more client-centred, equitable, and aligned with clinical practice. REPORTING

methodThis manuscript follows the short-form Guidance for Reporting Patient and Public Involvement (GRIPP2) checklist (Staniszewska et al., 2017) to ensure transparent reporting of the co-creation process, in which clients and healthcare professionals actively participated in the design, development, and evaluation of the intervention (Additional file 1. GRIPP 2).