The Pharmaceutical Journal
Vol 276 No 7386 p136-138
4 February 2006

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A novel, pharmacist-led strategy to reduce the prescribing of benzodiazepines in Paisley

By Ian Towle and Joan Adams

Abstract

Aim
To establish and assess a novel strategy to reduce prescribing of benzodiazepines

Design
Prescribing Intervention Study

Subjects and setting
369 patients aged 70 years and under with a repeat benzodiazepine prescription within 1 GP practice with 2 general practitioners.

Outcome measure
Primary outcome measure was number of patients with a benzodiazepine on repeat prescription before and after review. Secondary outcomes were quantities and prescribing rates (items/100patients) of benzodiazepines prescribed measured over a 3 year study period.

Method
After agreement with GPs, a benzodiazepine prescribing policy was developed and implemented. For suitable patients, the pharmacist prepared and calculated a prescription and stepdown regimen and sent a letter to patient inviting them for a GP appointment to discuss their prescription.

Results
96 patients had their prescription inactivated because it had not been requested for 3 months. 206 (56%) patients were invited for review and 151 attended and collected their stepdown regimen. 24 patients receiving a stepdown regimen were restarted on their original (or a lower) dose. Overall 85 (23%) of 369 patients remained on repeat prescription at end of project. Number of benzodiazepine tablets prescribed was reduced by 64% and benzodiazepine prescribing rate decreased by 67%.

Conclusions
The methodology provided a quick and effective method to assist GPs in reducing their benzodiazepine prescribing and was perceived to be a successful and worthwhile investment in time and resources. The pharmacist provided a pivotal role in this project with GP motivation and good communication between members of the team being important contributing factors.