Design, implementation, and evaluation of a pharmacist-led outpatient benzodiazepine-tapering clinic

Autor: Tania Gregorian, Kristin Bradley, Scott Campbell, Rachel Mashburn, Richard Beuttler, Michelle S. Keller
Rok vydání: 2023
Předmět:
Zdroj: J Am Pharm Assoc (2003)
ISSN: 1544-3191
DOI: 10.1016/j.japh.2022.09.025
Popis: BACKGROUND: Benzodiazepines are commonly used among older adults, despite well-known risks. Clinical pharmacists can lead tapering efforts, leveraging their clinical expertise and relieving time-pressured primary care providers. OBJECTIVES: The objective is to describe the design, implementation, and evaluation of an outpatient pharmacist-led benzodiazepine tapering clinic. PRACTICE DESCRIPTION: The clinic is based within a community medical group associated with a large academic health system in Los Angeles, California. PRACTICE INNOVATION: The clinic is staffed by clinical pharmacists and supervised by a psychiatrist. The initial visit consists of patient education, design of patient-driven tapering schedule, and medical history review. Follow-up phone/video visits are used to monitor withdrawal symptoms and provide support. EVALUATION METHODS: We used chart review to assess tapering status among those enrolled in the tapering clinic versus those who did not enroll. We compared outcomes across the two groups using bivariate statistics. RESULTS: From March 2017- May 2019, 176 patients were referred to the clinic; 17 were deemed ineligible. Of the 159 patients contacted, 62 patients enrolled in the clinic; 97 patients did not enroll. Among patients in the clinic, 13 (27%) of patients were tapered down, 29 (60%) completely tapered off, 6 (13%) were unable to taper, and 14 (23%) were in the process of tapering. In contrast, among patients who did not enroll, 3 (4%) of patients were tapered down, 15 (20%) completely tapered off, 57 (76%) were unable to taper, and 22 (22%) were in the process of tapering. 90% of patients had at least some benzodiazepine tapering when enrolled in the clinic compared to 41% among not enrolled in the clinic (p
Databáze: OpenAIRE