Quality improvement project regarding posttraumatic stress disorder (PTSD) and benzodiazepines as part of the Psychotropic Drug Safety Initiative (PDSI)

Introduction: Currently, there is a nationwide psychopharmacology quality improvement initiative within the VA deemed the Psychotropic Drug Safety Initiative (PDSI). One specific metric within this initiative is the proportion of patients with post-traumatic stress disorde(PTSD) and prescribed a benzodiazepine compared to patients with PTSD with no benzodiazepine prescription. The rationale for this measure is “to minimize the exposure of patients with PTSD to side effects and adverse events associated with benzodiazepines given lack of evidence supporting efficacy in treatment of PTSD symptoms.”

Objectives: This project aims to decrease the proportion of PTSD patients prescribed benzodiazepines to PTSD patients not prescribed benzodiazepines at the TVAMC.

Study Design: Prospective, quality improvement project. 

Methods: A baseline number was obtained of patients with a diagnosis of PTSD as well as a baseline number of patients with PTSD and an active prescription for a benzodiazepine. An encrypted email was sent to each identified prescribing physician with education regarding the PDSI initiative, risks associated with benzodiazepines, the lack of supporting evidence for use in PTSD, tapering strategies, alternative treatment options, as well as a list of his/her respective actionable patients. Pharmacy researcher will be available to meet with each provider for one on one consultation. Verbal and written education is also being provided to patients of PTSD and Substance Abuse groups. Four monthly reports will be generated tracking the proportion of PTSD patients prescribed benzodiazepines to PTSD patients not prescribed benzodiazepines. The final proportion will be compared to the baseline proportion to determine if the objective was met.

Results: In progress.

Conclusions: In progress.