Evaluation of a multicomponent educational intervention to decrease general practice registrars’ prescribing of benzodiazepines and related drugs: the BENEFIT prospective controlled study

Authors

  • Jordan Tait General Practice Training Research Department, Royal Australian College of General Practitioners, Level 1, 20 Mclntosh Drive, Mayfield West, NSW, 2304, Australia
  • Simon Holliday School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Elizabeth Holliday School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Irena Patsan School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Amanda Tapley School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Anna Ralston School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Jean Ball Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute (HMRI), 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
  • Mieke van Driel General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
  • Andrew Davey School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Alison Fielding School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
  • Michael Nicholas Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Reserve Road, St Leonards, NSW, 2065, Australia
  • Parker Magin University of Newcastle School of Medicine and Public Health http://orcid.org/0000-0001-8071-8749

DOI:

https://doi.org/10.33966/hepj.7.1.18084

Abstract

Background: Benzodiazepines and medicines (including Z-drugs) are associated with frequent and serious related adverse effects. Despite this, they are frequently prescribed by general practitioners (GPs). We aimed to evaluate the effectiveness of a multi-component educational intervention designed to decrease the prescribing and initiation of these drugs by GPs in training ('registrars').

Methods/design: A pragmatic non-randomised, non-equivalent control-group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study was used to assess an educational intervention delivered to registrars in Australia. The intervention was underpinned by the Behaviour Change Wheel framework and included face-to-face workshops with pre- and post-session readings, a webinar for supervisors, and facilitation of registrar-supervisor dyad interactions. Analyses employed univariable and multivariable logistic regression. The p-value of an interaction term in the multivariable regression was used to determine the statistical significance of intervention-related change.

Results: Analyses included data of 1,088 intervention registrars and 1,003 control registrars. While some decrease in prescribing was seen, compared to the change from pre-post in controls, there were no statistically significant decreases in the ‘Intention to Treat’ (interaction aOR = 0.92, 95%CI: 0.70, 1.20, p = 0.52) or ‘On Treatment’ (interaction aOR = 0.87, 95%CI: 0.65, 1.16, p = 0.33) populations, and no statistically significant decrease in new prescriptions in the ‘Intention to Treat’ population (interaction aOR = 0.88, 95%CI: 0.58, 1.35, p = 0.57).

Implications: Our study may have implications for further research aiming to identify effective strategies to promote appropriate benzodiazepine prescribing among GP registrars. Continued education for registrars around rational benzodiazepine prescribing is essential. This study is an initial step in evaluating the behaviour change intervention and further investigation and extended observation is warranted. This study highlights the educational challenges in improving rational benzodiazepine prescribing.

Limitations: Randomization in the study design was not practicable.

Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12618000824268

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Author Biography

  • Parker Magin, University of Newcastle School of Medicine and Public Health
    Conjoint Professor, Discipline of General Practice, School of Medicine and Public Health, University of Newcastle
Summary of editorial team and board

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Published

2024-09-18

Issue

Vol. 7 No. 1 (2024)

Section

Articles

How to Cite

Evaluation of a multicomponent educational intervention to decrease general practice registrars’ prescribing of benzodiazepines and related drugs: the BENEFIT prospective controlled study. (2024). Health Education in Practice: Journal of Research for Professional Learning, 7(1). https://doi.org/10.33966/hepj.7.1.18084