Benzodiazepines and non-benzodiazepine hypnotics - impact of a cluster adopted protocol on primary care prescribing

Christopher J. Weatherburn (Lead / Corresponding author)

Research output: Contribution to journalArticle

Abstract

Background and Aims: Reduction of benzodiazepines and non-benzodiazepine hypnotics (BZDs and Z-drugs) prescribing is a priority. Dundee, Scotland, has a total of 25 general practices, split into four clusters. The cluster with the highest recorded prescribing of BZDs and Z-drugs adopted a prescribing protocol that aimed to reduce such prescribing. This paper evaluates the impact of this protocol.

Methods: Quarterly prescribing data were obtained from Information Service Division, NHS Scotland from Q1 2015/16 to Q4 2017/18. Data were split into four clusters and standardised to Defined Daily Dose (DDDs) per 1000 registered patients. Interrupted time series (ITS) analysis was performed to assess prescribing one year after this protocol was introduced.

Results: There was a crude reduction in prescribing of BZDs and Z-drugs across all GP practice clusters, but this related to an ongoing downward trend in prescribing. Allowing for this, in the cluster that adopted the protocol, ITS revealed there was no significant reduction attributable to the intervention in prescribing of DDD equivalent doses (-0.4%, 95% CI: -7.2 to 7.6).

Conclusions: Introduction of a cluster-wide prescribing protocol did not provide significant reduction of prescribing. Although crude figures might suggest an improvement, ITS analysis revealed this not to be the case.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
JournalScottish Medical Journal
Volume64
Issue number3
Early online date12 May 2019
DOIs
Publication statusPublished - Aug 2019

Fingerprint

Hypnotics and Sedatives
Benzodiazepines
Primary Health Care
Scotland
Drug Prescriptions
Information Services
General Practice
Pharmaceutical Preparations
Interrupted Time Series Analysis

Keywords

  • Diazepam
  • benzodiazepines
  • interrupted time series analysis
  • prescriptions
  • primary health care

Cite this

@article{c3c79cd244e646169b894a89c752b0e2,
title = "Benzodiazepines and non-benzodiazepine hypnotics - impact of a cluster adopted protocol on primary care prescribing",
abstract = "Background and Aims: Reduction of benzodiazepines and non-benzodiazepine hypnotics (BZDs and Z-drugs) prescribing is a priority. Dundee, Scotland, has a total of 25 general practices, split into four clusters. The cluster with the highest recorded prescribing of BZDs and Z-drugs adopted a prescribing protocol that aimed to reduce such prescribing. This paper evaluates the impact of this protocol.Methods: Quarterly prescribing data were obtained from Information Service Division, NHS Scotland from Q1 2015/16 to Q4 2017/18. Data were split into four clusters and standardised to Defined Daily Dose (DDDs) per 1000 registered patients. Interrupted time series (ITS) analysis was performed to assess prescribing one year after this protocol was introduced.Results: There was a crude reduction in prescribing of BZDs and Z-drugs across all GP practice clusters, but this related to an ongoing downward trend in prescribing. Allowing for this, in the cluster that adopted the protocol, ITS revealed there was no significant reduction attributable to the intervention in prescribing of DDD equivalent doses (-0.4{\%}, 95{\%} CI: -7.2 to 7.6).Conclusions: Introduction of a cluster-wide prescribing protocol did not provide significant reduction of prescribing. Although crude figures might suggest an improvement, ITS analysis revealed this not to be the case.",
keywords = "Diazepam, benzodiazepines, interrupted time series analysis, prescriptions, primary health care",
author = "Weatherburn, {Christopher J.}",
year = "2019",
month = "8",
doi = "10.1177/0036933019849369",
language = "English",
volume = "64",
pages = "97--102",
journal = "Scottish Medical Journal",
issn = "0036-9330",
publisher = "SAGE Publications",
number = "3",

}

Benzodiazepines and non-benzodiazepine hypnotics - impact of a cluster adopted protocol on primary care prescribing. / Weatherburn, Christopher J. (Lead / Corresponding author).

In: Scottish Medical Journal, Vol. 64, No. 3, 08.2019, p. 97-102.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Benzodiazepines and non-benzodiazepine hypnotics - impact of a cluster adopted protocol on primary care prescribing

AU - Weatherburn, Christopher J.

PY - 2019/8

Y1 - 2019/8

N2 - Background and Aims: Reduction of benzodiazepines and non-benzodiazepine hypnotics (BZDs and Z-drugs) prescribing is a priority. Dundee, Scotland, has a total of 25 general practices, split into four clusters. The cluster with the highest recorded prescribing of BZDs and Z-drugs adopted a prescribing protocol that aimed to reduce such prescribing. This paper evaluates the impact of this protocol.Methods: Quarterly prescribing data were obtained from Information Service Division, NHS Scotland from Q1 2015/16 to Q4 2017/18. Data were split into four clusters and standardised to Defined Daily Dose (DDDs) per 1000 registered patients. Interrupted time series (ITS) analysis was performed to assess prescribing one year after this protocol was introduced.Results: There was a crude reduction in prescribing of BZDs and Z-drugs across all GP practice clusters, but this related to an ongoing downward trend in prescribing. Allowing for this, in the cluster that adopted the protocol, ITS revealed there was no significant reduction attributable to the intervention in prescribing of DDD equivalent doses (-0.4%, 95% CI: -7.2 to 7.6).Conclusions: Introduction of a cluster-wide prescribing protocol did not provide significant reduction of prescribing. Although crude figures might suggest an improvement, ITS analysis revealed this not to be the case.

AB - Background and Aims: Reduction of benzodiazepines and non-benzodiazepine hypnotics (BZDs and Z-drugs) prescribing is a priority. Dundee, Scotland, has a total of 25 general practices, split into four clusters. The cluster with the highest recorded prescribing of BZDs and Z-drugs adopted a prescribing protocol that aimed to reduce such prescribing. This paper evaluates the impact of this protocol.Methods: Quarterly prescribing data were obtained from Information Service Division, NHS Scotland from Q1 2015/16 to Q4 2017/18. Data were split into four clusters and standardised to Defined Daily Dose (DDDs) per 1000 registered patients. Interrupted time series (ITS) analysis was performed to assess prescribing one year after this protocol was introduced.Results: There was a crude reduction in prescribing of BZDs and Z-drugs across all GP practice clusters, but this related to an ongoing downward trend in prescribing. Allowing for this, in the cluster that adopted the protocol, ITS revealed there was no significant reduction attributable to the intervention in prescribing of DDD equivalent doses (-0.4%, 95% CI: -7.2 to 7.6).Conclusions: Introduction of a cluster-wide prescribing protocol did not provide significant reduction of prescribing. Although crude figures might suggest an improvement, ITS analysis revealed this not to be the case.

KW - Diazepam

KW - benzodiazepines

KW - interrupted time series analysis

KW - prescriptions

KW - primary health care

UR - http://www.scopus.com/inward/record.url?scp=85066950755&partnerID=8YFLogxK

U2 - 10.1177/0036933019849369

DO - 10.1177/0036933019849369

M3 - Article

VL - 64

SP - 97

EP - 102

JO - Scottish Medical Journal

JF - Scottish Medical Journal

SN - 0036-9330

IS - 3

ER -