Date of Award

5-2004

Level of Access Assigned by Author

Campus-Only Thesis

Degree Name

Master of Science (MS)

Department

Nursing

Advisor

Nancy Fishwick

Second Committee Member

Marcella Sorg

Third Committee Member

Carol Wood

Abstract

Research indicates that the number of accidental injuries related to benzodiazepines in Maine is escalating at an alarming rate. Nurse practitioners (NPs) and other medical professionals have key roles in reversing this alarming trend. In order for this to occur, research must be done to assess the knowledge, attitudes, and prescribing practices among NPs in Maine towards benzodiazepines. Benzodiazepines are a class of controlled drugs that were present in 37% of the drug-related fatalities in Maine from 1997 to 2002 either as a lone substance or taken along with other substances. Benzodiazepines are commonly prescribed for anxiety, muscle spasm, insomina, alcohol withdrawal, and seizure disorders. In addition to their potential for abuse, their side effect profile includes impaired judgment, drowsiness, respiratory depression, arrhythmias, blurred vision, vertio, diplopia, and confusion, all which contribute to their potential lethality. Physicians and NPs have the prescriptive authority to dispense benzodiazepines in Maine. No research has been undertaken concerning the knowledge, attitudes, and prescribing practices related to benzodiazepines among NPs. The purpose of this study is to describe these traits among NPs in Maine. Much of the national and international research investigated the factors that influence a provider's decision to prescribe a benzodiazepine, but only from the physician perspective. This study seeks to answer the questions: (a) what is the knowledge level of NPs in Maine specific to benzodiazepines, (b) what are the attitudes among NPs in Maine towards benzodiazepines as a therapeutic agent, and (c) what are the medical conditions and settings in which NPs in Maine prescribe benzodiazepines. The method used for this research was a 38-item, mailed questionnaire intended to assess factors influencing a NP's decision to prescribe benzodiazepines.Out of 536 questionnaires mailed to licensed NPs, 255 questionnaires were returned, yielding a return rate of 48%; 245 questionnaires met the inclusion criteria. These 245 respondents were broken into two sub-groups, those who could and did prescribe benzodiazepines (prescribers) and those who could or did not prescribe benzo diazepines (non-prescribers). The findings indicated that prescribers have a generally high level of knowledge regarding benzodiazepines, but report deficits in a few areas. Out of 205 prescribers, 47% are unaware of established benzodiazepine prescribing guidelins, 31% believe that benzodiazepines are safe to use for greater than a two month period, and 21% are unaware of the high incidence of benzodiazepine abuse with alcohol. Respondent attitudes towards benzodiazepines are, by and large, negatve and somewhat homogenous. Respondents generally prescribed benzodiazepines sparingly and appropriately. The findings of this study have educational, clinical, and research implications. Twenty percent of the NPs reported a need for more education which could be met in a number of ways. For example, employers could provide updated information regarding benzodiazepines as well as offer updated benzodiazepine prescribing guidelins and resources to assist clinicians. The research community should continue to investigate benzodiazepines and their effect on the elderly and on cognitive impairmnet, as well as developing methods to assist the medical community in addressing the misprescription and misuse of these drugs.

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