Case Study: UPMC Western Psychiatric Hospital 2023 Achievement Award

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.

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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