Case Study: UPMC Western Psychiatric Hospital 2023 Achievement Award
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Process and Outcomes for Deprescribing Benzodiazepines in the Outpatient Setting for Adults with Intellectual Disabilities and Autism
Excellence in Care - Medium Division
The Goal
To propose a standardized process for benzodiazepine deprescribing in patients with ASD and/or ID in order to support prescribers and the interdisciplinary team members in preventing benzodiazepine morbidity prior to a serious drug event.
Intervention
This project began with a retrospective review of benzodiazepine use in a specialty psychiatric clinic for adults with ASD and ID. Patients were included in the report if they had a diagnosis of ASD and/or ID and were prescribed a scheduled benzodiazepine as part of psychiatric medication management from a participating project psychiatrist.
When patients taking scheduled benzodiazepines achieved stability in the psychiatric indication for which the medication was initiated, providers discussed initiating a benzodiazepine taper with patients and/or caregivers as part of usual care. Rate and amount of taper was customized based on the clinical situation, comorbid conditions, and patient/caregiver comfort. Taper tolerability and symptom stability were monitored during in person and telehealth visits.
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Results
Initial data analysis identified that the study group was able to successfully taper benzodiazepines in patients with ASD and/or ID without worsening of psychiatric stability or requiring additional psychotropic medications. A subset of patients completely discontinued their scheduled benzodiazepine while others have significantly reduced their dose while continuing to work towards a goal of discontinuation. Ongoing data analysis will continue to inform key characteristics of successful deprescribing cases to inform a standardized benzodiazepine deprescribing process in this population.
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Topics: Quality Initiatives
Revision Date: 2/28/2023
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