Audit as a method of reducing benzodiazepine prescribing in general practice

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Abstract
Background: Many audits in primary care can be criticized because of the absence of verifiable data to measure outcomes, and the lack of a non‐participating group against which to compare results. Objective: Using Prescribing Analyses and Cost (PACT) data to quantify the effect of an audit in 15 practices. We sought to quantify the effect of the audit of benzodiazepine prescribing in a district by measuring the detailed changes in prescribing in participating practices before, during and after audit, and by comparing the volume of prescribing of these drugs in participating and neighbouring non‐participating practices. Methods: At the start of the audit, 291 993 patients in the Sefton district of North West England were registered with 55 general practices. Fifteen practices, caring for 87 902 patients, took part in an audit of benzodiazepine prescribing. We analysed routinely‐collected prescribing data to assess trends in benzodiazepine prescribing for those practices which took part in the audit and the remaining (non‐participatory) practices in the district. Main measures: The number of defined daily doses of benzodiazepine prescribed by those general practitioners auditing their prescribing of these drugs during the audit. The volume of benzodiazepines prescribed by all general practitioners in Sefton during the quarter immediately before and the quarter immediately after the audit. Results: There was a significant reduction in the number of defined daily doses dispensed for temazepam, nitrazepam, and lorazepam during the audit. There was a significantly greater reduction in the number of items prescribed by those doctors who took part in the audit than their colleagues who did not. Conclusions: An audit of benzodiazepine prescribing achieved a significant reduction in the volume of these drugs dispensed. An analysis of routinely‐collected data can usefully measure the result of an audit of prescribing.