Blog | Friday, April 18, 2014

QD: News Every Day--Pharmacists may be effective in reducing inappropriate benzodiazepine use

Direct-to-consumer education by pharmacists led to a reduction in the amount of inappropriate benzodiazepine use in patients older than 65, a study found.

To compare the effect of a direct-to-consumer educational intervention against usual care on benzodiazepine therapy discontinuation in community-dwelling older adults, 30 community pharmacies in Quebec, Canada were randomized 1:1 to the educational intervention (148 patients) or to the control group (155 patients).

The intervention arm received an 8-page booklet outlining the risks of benzodiazepine use, presentation of the evidence for benzodiazepine-induced harms, education about drug interactions, peer champion stories, suggestions insomnia and/or anxiety substitutes, and stepwise tapering recommendations. The control arm received usual care. Results appeared online April 14 at JAMA Internal Medicine.

A total of 261 participants (86%) completed the 6-month follow-up. Of the recipients in the intervention group, 62% talked to a physician and/or pharmacist about stopping benzodiazepine. At 6 months, 27% of the intervention group had stopped benzodiazepine compared with 5% of the control group (risk difference, 23%; 95% CI, 14% to32%; number needed to treat, 4) or had reduced their dose (risk difference, 11%; 95% CI, 6% to 16%).

Researchers noted that patients reported that their physicians discouraged discontinuation of benzodiazepines in several cases, that benzodiazepines were sometimes substituted with equally harmful sedatives, and that pharmacists were solicited less often than physicians to discuss stopping benzodiazepine therapy.

“With the expanding scope of pharmacists’ practice and an increasing emphasis on interprofessional models of care, community pharmacists may be underutilized players to participate in efforts to reduce costly and unnecessary medical treatments,” the authors wrote.