Future directions
Our findings of low engagement raise the question where and how we can find the patients who are ready and willing to taper. Participants did not actively ask for support but were invited in the context of the study. An alternative approach could be to target our interventions at those who actively request taper support. However, from previous studies we know that patients believe that it is the doctor’s responsibility to initiate the conversation about tapering ADM [In addition, new forms of support are being developed, such as ADvisor [Work or travel issues were most often mentioned as barriers to participation. Therefore it would be interesting to include different formats of MBCT, such as stand-alone, blended or therapist-assisted online mindfulness interventions. At the same time, this might challenge the possibly important role of peer support that emerged from the post-MBCT interviews with a subsample of the patients. Video-conferencing programs would overcome the issue of travel time, and may be more appealing for patients with physical problems. In stand-alone interventions, audiovisual materials such as interviews with ‘peers’ who tell about their experiences might help to connect with others’ experiences. Similar adaptations can also be considered for SPD or other forms of monitoring in primary care.Furthermore, we might consider partial rather than full discontinuation as a valid outcome as well, given the evidence that most withdrawal problems might occur at the lowest doses [