A confidential enquiry into methadone-related deaths.
OBJECTIVE
To assess the acceptability and usefulness of the "confidential enquiry" process in examining methadone-related deaths.


METHODS
An audit of patient care.


METHODS
Glasgow, Scotland, UK (population 915,000) Participants. All doctors who, in the final 14 days of the patient's life, had attended a patient who suffered a methadone-related death.


METHODS
The medical care of each case was assessed by peer review and the results of these assessments returned to the responsible clinician(s).


RESULTS
(1) The audit cycle was completed in 32 of the 34 reported cases (94%). (2) Twenty-eight of 33 doctors (85%) found the audit to be helpful. (3) As a result of the enquiry, the majority of doctors whose patient management had attracted criticism intended to amend their practice. (4) Shortcomings in clinical care were identified in 18 cases (56%) and problems in the organization of services in 22 (69%).


CONCLUSIONS
(1) The model of audit piloted here was found to be highly acceptable to participants. (2) The episodes of substandard care that were uncovered provided useful opportunities to improve the future management of patients who were being prescribed methadone.
Scott
R T
RT
Glasgow Drug Problem Service, Woodside Health Centre, Scotland, UK.
Jay
M J
MJ
Keith
R
R
Oliver
J S
JS
Cassidy
M T
MT
D003219:Confidentiality; D006801:Humans; D008485:Medical Audit; D008691:Methadone / Q000009:adverse effects*; D005791:Patient Care / Q000592:standards*; D012606:Scotland / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000401:mortality*; D011795:Surveys and Questionnaires
D008691:Methadone