Objective:
Recently, the use of benzodiazepines (BZD) and cyclopyrrolones
(CP) has drawn a great deal of attention. About 100,000 patients
- approximately 2% of the Danish population - are believed to
be addicted to BZD. This article describes a simple and effective
method of reducing the use of dependency-producing drugs in clinical
practice.
Methods: Design: Local rules were implemented according to Danish
directive CIR nr 12 13/01/2003 regarding addictive drugs. Prescriptions
for BZD and CP were only issued on a monthly basis, and only following
personal consultation. This monthly requirement forced the physician
as well as the patient to evaluate whether the existing prescription
pattern was indicated, or whether a drug-reducing regime should
be introduced. The prescription pattern was monitored using the
Ordiprax System (Institute for Rational Pharmacotherapy, IRF),
which records pharmacy's sales of prescription drugs as prescribed
by clinical practices. Two individual clinics in Thyborøn
- Harboøre Community, covering some 2300 patients, were
surveyed. All patients using BZD or CP were included in this study,
with the exception of patients suffering from serious psychiatric
or physical disorders.
Results: After 15 months, the use of BZD and CP was reduced by
50% and 75%, respectively. The process of changing prescription
habits was far easier than expected. A whole group of patients,
initially invisible to the physician, was exposed. During the
first three months, as few as 4-5 additional consultations for
every 1000 patients was required. There was essentially no need
for assistance from our usual partners, including psychiatrists,
hospitals, specialist units for addictive treatment.
Conclusion: We strongly recommend that these simple procedures
be incorporated into daily routine when prescribing either a BD
or a CP.
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