Objective: To evaluate the effect of patient-specific prescriber feedback on the prescribing of long-acting benzodiazepines in the veteran community in Australia.
Design: A pre and post intervention analysis of prescribing data.
Materials and Methods: Pharmacy claims from Australia’s Pharmaceutical Benefit Scheme (RPBS), which provides medications to eligible Australian veterans, were analyzed to identify veterans who were prescribed the long-acting benzodiazepine diazepam, nitrazepam and flunitrazepam (L-BZD). Feedback in the form of mailed letters, including patient-specific drug utilisation data, was sent to all Local Medical Officers (LMOs) prescribing L-BZD to at least one patient. The feedback suggested a review of their patients’ benzodiazepines, and included information on L-BZDs in older people. Prescribing for these patients 12 months later was analyzed for any changes.
Results: Some 7,400 LMOs were mailed, prescribing L-BZDs to 16,749 patients. The analysis was adjusted for the 1,140 patients who had died by the 12 month follow-up. The remaining 15,609 patients at baseline, with mean age of 76, were prescribed 16,337 L-BZDs. At follow-up 10,078 of these patients were still prescribed a L-BZD, a reduction of 35% and 10,401 different L-BZDs were prescribed to them, a reduction of 36%. The average cost of these drugs per patient using them fell from $8.00 to $6.01, a reduction of 25%, against an overall increase of 21% in drug costs for all utilizing veterans over that 12 month period. Prescriber satisfaction survey results suggest that the feedback was generally well received.
Conclusion: Patient-specific targeted prescriber feedback had a positive impact on the utilization of long-acting benzodiazepines in the Australian veteran community.
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