Category: Federal Forum Posters
Purpose: To decrease the number of patients in a Veteran Affairs health care system who are receiving dual therapy of stimulants and benzodiazepines. After a chart review of patients with both medications prescribed to them, the data suggested that in some cases, the mechanisms and side effects of these medications were being used to offset the undesirable effects of the other. Common side effects associated with the stimulant class are: agitation, anxiety, irritability, logorrhea, euphoria, and insomnia. In contrast, the common side effects associated with the benzodiazepine class are: somnolence, depression, confusion, and respiratory depression.
Methods: Data is obtained on national Strategic Analytics for Improvement and Learning (SAIL) measures and accessed via a Veteran Affairs created database that can be accessed for each region. The database indicates 95 Veterans prescribed both a benzodiazepine and a stimulant in the Gulf Coast Veterans Health Care System. There were a total of 21 prescribers writing these prescription. Of the 95 stimulant orders, 50 were written by 3 of the 21 prescribers. Prescribers of dual therapy were provided information reminding them of the risks of using this combination and offering possible methods to reduce dual prescribing and alternative options. Brochures were also sent out to patients on the combination of medications discussing the safety concerns with both medications and encouraged patients to discuss the potential of discontinuing one or both medications with their physician. The amounts of stimulants prescribed without a matching the Federal Drug Administration’s indicated diagnosis, was also evaluated in this study.
Katherine Morgan– PGY1 Pharmacy Resident, Gulf Coast Veteran's Health Care System, Gulfport, MS