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RACGP response: Coroners Court of Victoria, Investigation into the death of David A Trengrove

20 August 2012

As requested, a statement of action that has and/or will be taken by the RACGP in relation to the recommendations made by the Coroner (sections 72 (3) and 72 (4) of the Act) is outlined in this letter in response to recommendations 2 and 4 made to the RACGP.

Recommendation 2:

To reduce the harms and death associated with benzodiazepine use in Victoria, the Royal Australian College of General Practitioners should update its guidelines for appropriate prescribing of benzodiazepines in the context of general practice within 12 months. The updated guidelines should explicitly address the following areas:

  1. general principles for benzodiazepines prescribing
  2. appropriate use of benzodiazepines to treat specific conditions such as insomnia, anxiety and panic disorder
  3. strategies for identifying and treating patients who are seeking benzodiazepines in excess of medical need
  4. managing the risk of harm and death associated with benzodiazepine use and misuse.

RACGP response to Recommendation 2:

The RACGP confirms that the Coroner's recommendations will be implemented. The College agrees that the 2000 benzodiazepines guidelines do not reflect current advances in evidence and has therefore removed these from the website until they can be updated.

Whilst the RACGP acknowledges the Coroner's urgency, guideline development and/or update, must follow existing protocols and processes to ensure rigour and effectiveness within general practice and can often take longer than a twelve month period.

As part of the update, the Coroner's recommendations to address specific areas will be considered. These include: (a) general principles for prescribing (b) appropriate use of benzodiazepines to treat specific conditions such as insomnia, anxiety and panic disorder (c) strategies for identifying and treating patients who are seeking benzodiazepines in excess of medical need and (d) managing the risk of harm and death associated with benzodiazepine use and misuse.

The RACGP can confirm involvement of key members of the RACGP's National Networks of Addiction, Pain Management and Psychological Medicine1. The update will be guided by internal policies and procedures in the development of evidence-based clinical guidelines and include systematic review, project scoping using the RACGP Quality Framework2; formation of a clinical working group and adherence to NHMRC3 and AGREE II 4 standards in the development of guidelines.

The activities described above relate to recommendation 2 and also apply to recommendation 4.

 

The Royal Australian College of General Practitioners

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