Effectiveness of Clinical Audit and Coaching for Quality Improvement Activities on Appropriate Use of Benzodiazepine Receptor Agonists in Community Clinics

西村 正大, 西岡 大輔, 伊藤 ゆり, 中村 正和, 望月 崇紘, 藤原 直樹, 山下 大輔

doi:10.60261/chiikiigaku.38.2_50

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地域診療所におけるベンゾジアゼピン受容体作動薬の適正使用に関する質改善活動のための診療監査とコーチングの効果
チイキシンリョウジョニオケルベンゾジアゼピンウケヨウダイサドウヤクノテキセイシヨウニカンスルシツカイゼンカツドウノタメノシンリョウカンサトコーチングノコウカ

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<p>Objective　To determine the effectiveness of a quality improvement intervention on the appropriate use of benzodiazepine receptor agonists (BZRAs) in community clinics. Methods　Nine clinics of JADECOM(Japan Association for the Development of Community Medicine) were assigned to either audit only group or audit plus coaching group. The percentage of patients prescribed BZRAs (Measurement 1) and the amount of BZRAs prescribed per patient panel (Measurement 2) were measured monthly, and feedback was provided. Coaching clinics had additional monthly online coaching sessions. Results　In the statistical process control analysis, downshifts occurred more frequently in the audit + coaching groups than in the audit only group (2vs5). Difference-in-differences analysis showed an improvement in the amount of BZRAs prescribed in the audit only group (index 1: -0.62％, p=0.06) and index 2: -0.32 tablets, p=0.03). In the coaching group, the amount of change increased but did not reach statistical significance (index 1: -0.95％, p=0.48), index 2: -0.37 tablets, p=0.80). Conclusions　The results suggest that quality improvement activities on the use of BZRAs for local clinics may be effective for some indicators.</p>

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Monthly Community Medicine

Monthly Community Medicine 38 (2), 50-, 2024-02-10

Japan Association Development of Community Medicine

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