AIM- This study aims to evaluate the diazepam prescriptions of women on the Prepare team caseload to determine whether women with benzodiazepine dependence are receiving a gradual reduction of a long acting benzodiazepine as in WHO guidelines. It also aims to explore the barriers to reducing diazepam prescription and evaluate whether women receiving treatment are satisfied with the service that is provided.
METHOD- Prepare is a service that works with women with substance misuse in pregnancy in Edinburgh. Patients prescribed diazepam in Prepare ‘s active caseload were identified and these prescriptions audited for changes in prescription during their engagement with the service. These patients were interviewed using a qualitative questionnaire designed to gain an understanding of their drug use, lifestyle, experience of pregnancy and their views on the service Prepare provides.
RESULTS- Only 16.7% of women had their diazepam dose reduced during pregnancy. A further 16.7% had their dose decreased postnatally. The rest remained unchanged or increased. Half of patients found Prepare encouraged them to stop illicit drug use and 66.7% felt they had gained an understanding of the effects of drugs in pregnancy.
CONCLUSION- Patients found Prepare helpful and supportive, but diazepam prescriptions were not reduced in line with guidelines. More effort needs to be made to reduce the dose, however this can be difficult as there are barriers to doing so. These recommendations were discussed at a multidisciplinary team meeting and it was agreed that reduction of benzodiazepine use in pregnancy should be addressed more consistently through the service.
Dr Michael Kehoe, Consultant Psychiatrist, NHS Lothian
Conflicts of interest:
No conflict of interest