Study, Aug. 2015: The French "pay-for-performance" program re: Benzodiazepines

This abstract gives only a brief summary of the subject matter, so it's a bit cryptic. The full title is "The true impact of the French pay-for-performance program on physicians’ benzodiazepines prescription behavior".

 

Without having further details, it's difficult to understand whether these doctors are being paid to remove patients from benzos, or not start them in the first place. We can only hope that no patient was forced to cold-turkey or to do a rapid taper as a result of this initiative.

 

http://link.springer.com/article/10.1007%2Fs10198-015-0717-6

Thanks, Lapis. I too wonder if it means not scripting the stuff to begin with, or asking GPs not to perform benzo tapering.

Bets

Also questionable is the motivation -- money! There's no discussion of patient safety, or side effects, or withdrawal.

Lapis, I found this information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105521/

 

Although I didn't read the whole thing, as it'll take awhile, it sounds as if those physicians who got their patients off benzos were given money. Here it is in part: "French general practitioners (GPs) were enrolled in a new payment system in January 2012. As part of a national agreement with the French National Ministry of Health, GPs were asked to decrease the proportion of patients who continued their benzodiazepine treatment 12 weeks after its initiation and to decrease the proportion of patients older than 65 who were prescribed long half-life benzodiazepines. In return, GPs could expect an extra payment of up to 490 euros per year. This study reports the evolution of the corresponding prescribing practices of French GPs during that period regarding patients who were prescribed a benzodiazepine for the first time."

 

I'll have to read the rest of it when I have more time.

 

Thanks for looking that up, Terry. Worrisome. You can bet that people were tapered too fast or just cold turkeyed.

 

As an aside, I was thinking of the people of France the other night while watching a longer-format news item about the post-attack trauma many of them are feeling. I can only imagine what they're going through. I wondered, too, whether there might be more benzo and antidepressant prescriptions as a result of everything that has happened.

Yes, Lapis, that is a troubling thought, that more benzo and AD prescriptions might have been prescribed due to post-attack trauma, although the French do have a way of coping by gathering in cafes and talking a lot. They have that going for them.

 

I think that what the world needs more of is what the French have been doing for a very long time - talking in groups at cafes. Here in the U.S., people are so busy, and so proud of being busy, that spending the time discussing their lives, fears, whatever, has gone by the wayside. In the U.S. sitting and discussing lives isn't done enough because there's more interest in having a number of irons in the fire. People in the U.S. often brag about how busy they are. It's a source of pride to tell people that we're so busy that we don't get enough sleep. But that's okay because so many others feel the same way. In cafes here, people are glued to their laptops or their smartphones. Yet talking things out with others helps us to feel less alone. It can help take a large weight off the shoulders. And maybe it would cut down on the number of prescriptions and visits to the psychiatrist. Well, it's a thought, anyway.

 

It's always a worry to me that doctors and even pharmacists are not getting it when it comes to tapering. Even with the doctors I've been to, I've been given some really bad advice about tapering off bp pills - essentially to just quit taking the drug altogether. I've had to undo the damage regarding what a doctor has told me to do and have had to start all over with a much, much slower taper plan with bp pills.

Hi Terry,

As someone living on the other side of the border, I never feel it's my place to make a statement on US life. But I do know a number of people there, and what you're saying rings absolutely true when I think of them. As for the French, I'm hoping that their resilience and mutual support will carry them through the dark days. Watching that news video was very moving. The people are back at the cafes -- talking, etc. -- so let's hope you're right about their cafe culture being a source of support and strength.

 

 

 

 

Yes, Lapis, I hope the cafes offer support and comfort instead of the double-edged swords, the pills!