Implementation of a Benzodiazepine Clinical Practice Guideline in an Outpatient Mental Health Setting

In the treatment of mental health disorders, the use of benzodiazepines is increasingly falling out of favor due to rising evidence concerning the risk of abuse and dependence. Despite the evidence against such use of benzodiazepines, there is a lack of provider-focused intervention designed to discourage the use of benzodiazepines; or, promote the use of benzodiazepine-alternative treatments. Previous interventions designed to decrease benzodiazepine use are almost exclusively patient-centered and do not address the provider's role in the propagation of these types of drugs. In this study provider-centered interventions to decrease benzodiazepine prescribing were explored including the creation and implementation of a benzodiazepine clinical practice guideline, and desk reference materials. Prescribing data was collected for pre- and post-intervention timeframes and analyzed these data for changes in benzodiazepine prescribing rates on 579 patient cases. Pre- and post-intervention surveys were also completed to explore the prescribers' views of clinical practice guidelines. There were no statistically significant decreases in benzodiazepine prescribing after implementation of the clinical practice guideline for 2 months. The pre-intervention semi-structured interviews revealed 3 themes related to clinical practice guidelines: they are welcome in the outpatient setting, they enhance evidence-based care, and that they are not as prevalent as they should be. Post surveys revealed that the guideline was perceived as highly usable, readily available, and all providers reported regular use of the guideline. More study is needed over a longer period of time to determine true effectiveness of this program.