Alprazolam Prescribing in Tasmania: A Two-Fold Intervention Designed to Reduce Inappropriate Prescribing and Concomitant Opiate Prescription

Abstract

Objective: The population rate of alprazolam prescribing in Tasmania has been more than double that of national rates. Serious adverse events have been observed through co-administration of opioid medications with alprazolam. A two-fold intervention, comprising GP education coupled with changes to prescribing regulations, was designed with the intention to decrease inappropriate prescribing of alprazolam and thereby reduce adverse outcomes. The aim of this study was to assess the impact of the intervention on prescribing rates. Method: We measured the number of alprazolam prescriptions for the years prior to and the year following the intervention. Health Insurance Commission data were utilized to enable comparison of subsidized prescription rates for alprazolam in Tasmania, and compared with national data. Participants were registered medical practitioners in Tasmania who were potential prescribers of alprazolam. The interventions were three GP Education Meetings during June 2007, one in each of the major regions of Tasmania, regarding evidence-based interventions for panic disorder. Changes to regulatory procedures to minimize co-prescription of alprazolam with opioids was implemented in September 2007. Results: A reduction in alprazolam prescribing in Tasmania occurred after the interventions. Conclusion: Education can be an effective strategy to influence prescribing behaviour of doctors. It is likely that this effect can be augmented by adoption of more stringent regulatory requirements.