Guideline, education, and peer comparison to reduce prescriptions of benzodiazepines and low-dose quetiapine in prison

J Correct Health Care. 2012 Jan;18(1):45-52. doi: 10.1177/1078345811421591. Epub 2011 Sep 30.

Abstract

Benzodiazepines (antianxiety medications) and quetiapine (an antipsychotic medication) are subject to abuse in prison. Quetiapine is also expensive and has serious side effects. The prescription of these medications in prison for anxiety and insomnia is not the preferred choice. In order to reduce these prescriptions, the University of Medicine and Dentistry of New Jersey-University Correctional HealthCare (UCHC), working within the New Jersey Department of Corrections, provided its psychiatrists with a guideline to the treatment of insomnia in prison. The guideline discouraged pharmacological treatment of insomnia. UCHC then anonymously compared the prescribing practices of its psychiatrists to each other, and educated the psychiatrists about the disadvantages of benzodiazepines and low-dose quetiapine in prison. These techniques reduced the numbers of inmates prescribed benzodiazepines by 38% after 20 months and reduced the numbers of inmates prescribed low-dose quetiapine by 59% after 22 months.

MeSH terms

  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / therapeutic use
  • Benzodiazepines / administration & dosage*
  • Benzodiazepines / therapeutic use
  • Dibenzothiazepines / administration & dosage*
  • Dibenzothiazepines / therapeutic use
  • Drug Utilization / standards
  • Drug Utilization / statistics & numerical data
  • Guideline Adherence / statistics & numerical data*
  • Health Education / methods
  • Health Education / statistics & numerical data
  • Humans
  • New Jersey
  • Peer Group*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data
  • Prisons / statistics & numerical data*
  • Psychiatry / statistics & numerical data
  • Quetiapine Fumarate
  • Sleep Initiation and Maintenance Disorders / drug therapy

Substances

  • Antipsychotic Agents
  • Dibenzothiazepines
  • Benzodiazepines
  • Quetiapine Fumarate