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Prescription Reduction Programme Proved a Success

2018-10-17

(Left to right): Fiona McConnell, HSCB and Maureen Hetherington, NHSCT, pictured with Benzodiazepine and Z-drug Reduction Programme staff, Bronagh McCann, NHSCT; Pamela McClean, NHSCT and Louise Trueman, NHSCT

The success of a new initiative to help patients reduce or stop their dependence on Benzodiazepine and Z-drugs is being celebrated today (17 October).

The Benzodiazepine and Z-drug Reduction Programme was introduced as a pilot by the Northern Local Commissioning Group of the Health and Social Care Board and the Northern Health and Social Care Trust.

The high use of benzodiazepines in Northern Ireland is well known and was highlighted as an issue by Dr Michael McBride, Chief Medical Officer in 2015. Benzodiazepine dependence often occurs with long term use and can result in harmful side effects including impaired cognitive abilities, memory problems and mood swings. Traditional methods of drug withdrawal have proved difficult for many people.

Recognising the significantly high use of this medication in the Northern area, the Northern Local Commissioning Group responded to the challenge. Through discussions with health and social care professionals and other stakeholders an innovative approach was piloted between January 2017 and March 2018 in five GP practices within the Northern area (Cookstown, Ballymena, Carrickfergus and Antrim). Uniquely, the pilot combined expert knowledge, support and intervention from a pharmacist and a specialist nurse working with the patient’s GP. This led to significant clinical benefits for patients as they received support alongside a bespoke withdrawal programme.

An evaluation was recently undertaken by the Regional Medicines Optimisation and Innovation Centre to determine the impact. Of the 836 patients who participated, 65% (546) reduced and stopped taking benzodiazepines/z-drugs; a further 25% (205) either stabilised on a lower dose or continued on the reduction programme.

Dr Olive Buckley, GP at Scotch Quarter Practice, Carrickfergus outlined the issues; “Our practice was one of the highest prescribers of benzodiazepines in the Northern area. In my 28 years in the Practice we have never been able to successfully reduce our prescribing of benzodiazepines. It seemed an impossible task. However, through the Programme, we have significantly reduced our prescribing rates.
“For some patients, it also unmasked underlying trauma and they were subsequently able to access the appropriate help. I would encourage other GP practices to engage with this initiative. It’s not only better for the practice and patients but it also reduces the volume of prescription drugs which are open to misuse in the community”.

Benefitting from the programme, one patient said; “I had tried to come off the tablets before but found it too hard. However, with support from the pharmacist and specialist nurse, I managed to cut them right down and now I’m off them completely. I feel much brighter, more alert and my family has noticed a change in my mood.”

Valerie Watts, Chief Executive, HSCB announced that, in light of the excellent results, the service will now roll out in the Northern area enabling other GP Practices to have the opportunity to avail of the support.

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