title: Reducing Problematic Benzodiazepine Use Among Individuals Enrolled in Methadone Treatment Programs.
abstract: The purpose of this study was to decrease problematic benzodiazepine (BZD) prescriptions provided to patients enrolled in methadone maintenance treatment (MMT) programs in an urban setting through a quality improvement intervention.
  
  
  
  A prospective, interactive, feedback loop was used with 4 MMT providers over a period of 5 years (2009-2013) to help reduce the number of BZD prescriptions that clients were receiving from other providers. To track individuals who were receiving a BZD prescription from an outside provider, MMT medical teams were provided with patient-level Medicaid pharmacy claims data every month for 5 years. A technical assistance team, comprised of a medical director, pharmacists, data analysts, clinical, and management information staff at a behavioral health managed care organization experienced in MMT, met with each of the 4 MMT providers at several time points to devise methods of reducing problematic BZD prescriptions and engaging community medical providers.
  
  
  
  A total of 3464 Medicaid eligible adults were included in the quality improvement project over the 5-year period. The overall rate of BZD prescriptions provided to patients decreased significantly, from 37% at the beginning of 2009, to 27% at the end of 2013. Three out of the 4 MMT programs showed a significant decrease in BZD prescriptions among their participants.
  
  
  
  The 4 MMT providers involved in the study found the ongoing feedback loops valuable in the process of managing the health risks of their MMT patients.
authors.affiliation: Community Care Behavioral Health Organization (JMS, DL, MP, AC, KC), UPMC Insurance Division; and HM Health Solutions, Inc. (NM), Pittsburgh, PA.
authors.forename: James M
authors.initials: JM
authors.lastname: Schuster
authors.forename: David
authors.initials: D
authors.lastname: Loveland
authors.forename: Meghna
authors.initials: M
authors.lastname: Parthasarathy
authors.forename: Nicole
authors.initials: N
authors.lastname: Maiolo
authors.forename: Alyssa
authors.initials: A
authors.lastname: Cilia
authors.forename: Kim
authors.initials: K
authors.lastname: Castelnovo
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects*; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care; D063487:Prescription Drug Misuse / Q000517:prevention & control*; D058996:Quality Improvement / Q000592:standards*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines; D008691:Methadone