This was a quality improvement project with the aim of reducing patient harm from long term prescribing and empowering prescribers by increasing their knowledge of non-pharmacological strategies to promote good sleep and mental wellbeing.
It also highlighted the role social prescribers and occupational therapists can play in managing patients with these problems.The medicines optimisation team carried out searches at each practice to highlight patients (2/1000 list size was the minimum expectation) who would be suitable for a medication review with a view to deprescribing of their high dose benzodiazepines or z-drugs.
Mindful of risk we excluded patients who were actively under the care of the mental health team, palliative care, neurology, and those under the care of substance or alcohol misuse services. The project has resulted in more than 500 patients across Sussex reduce and stop their benzodiazepine or z-drug. A further 1000 have engaged in successfully reducing their dose. There is also a notable decrease in the overall prescribing of these medicines across NHS Sussex and practices have reported a shift in culture when managing conditions such as anxiety and poor sleep. Where medicines have been newly started, it is prescribed for no more than 14 days, reviewed regularly and not put on to the repeat template. Patients are also given information that the medicines can cause dependence and for this reason will only be prescribed short term until a suitable non-pharmacological approach has time to take effect..
