MDU advises members on prescribing benzodiazepines
The Medical Defence Union (MDU) has provided advice to its members about prescribing benzodiazepines following media coverage on BBC 5 Live recently.
MDU medico-legal adviser Dr Nicola Lennard said drug-related deaths in England and Wales reached their highest recorded level in 2015, according to Office for National Statistics (ONS) data, which has led to concern about the availability of both legal and illegal drugs.
The MDU has reviewed the last six years of advice and claims cases which centre on either opiate or benzodiazepine medication. Most cases relate to coroner’s inquiries and inquests, but there were also a small number of negligence claims settled against GPs. Between 2010 and 2016 the MDU paid out almost £750,000 in compensation and legal costs on behalf of members involved in 11 cases.
Dr Lennard said: “The GMC’s guidance Good practice in prescribing and managing medicines and devices indicates that you should only prescribe medicines if you a have an adequate knowledge of the patient’s health and you are satisfied that they serve the patient’s needs.
“If a patient asks for medication that you do not think will benefit them you do not have to provide it for them, you should explain your reasons to the patient and any other options that are available including seeking a second opinion.
“In addition it’s important to have systems in place to review medications, particularly if the medicines have common or serious side effects or if they are controlled drugs or another medicine that is commonly abused or misused.”
The MDU has published advice to members on its website when considering prescribing a potentially addictive medication, which includes:
-
Be aware of the relevant NICE guidance including CG113, CG115 and CG159 and also review the BNF’s guidance on prescribing drugs likely to cause dependence.
-
If it is appropriate to prescribe a potentially addictive drug, clearly document the reason for the prescription, the alternatives considered, the duration of the treatment proposed and the side effects that have been explained to the patient.
-
Make sure adequate systems are in place to review the medication and that at each review the appropriateness of the medication is reconsidered in line with the GMC’s guidance.
-
Be aware that patients who may appear to have drug seeking behaviour could have another underlying diagnosis. Make sure that you undertake a thorough history and examination and document this carefully in the medical records.
