AIM: To assess the acceptability and usefulness of the "confidential enquiry" process in examining methadone-related deaths. DESIGN: An audit of patient care. SETTING: Glasgow, Scotland, UK (population 915,000) Participants. All doctors who, in the final 14 days of the patient's life, had attended a patient who suffered a methadone-related death. MEASUREMENTS: The medical care of each case was assessed by peer review and the results of these assessments returned to the responsible clinician(s). FINDINGS: (1) The audit cycle was completed in 32 of the 34 reported cases (94%). (2) Twenty-eight of 33 doctors (85%) found the audit to be helpful. (3) As a result of the enquiry, the majority of doctors whose patient management had attracted criticism intended to amend their practice. (4) Shortcomings in clinical care were identified in 18 cases (56%) and problems in the organization of services in 22 (69%). CONCLUSIONS: (1) The model of audit piloted here was found to be highly acceptable to participants. (2) The episodes of substandard care that were uncovered provided useful opportunities to improve the future management of patients who were being prescribed methadone.
AIM: To assess the acceptability and usefulness of the "confidential enquiry" process in examining methadone-related deaths. DESIGN: An audit of patient care. SETTING: Glasgow, Scotland, UK (population 915,000) Participants. All doctors who, in the final 14 days of the patient's life, had attended a patient who suffered a methadone-related death. MEASUREMENTS: The medical care of each case was assessed by peer review and the results of these assessments returned to the responsible clinician(s). FINDINGS: (1) The audit cycle was completed in 32 of the 34 reported cases (94%). (2) Twenty-eight of 33 doctors (85%) found the audit to be helpful. (3) As a result of the enquiry, the majority of doctors whose patient management had attracted criticism intended to amend their practice. (4) Shortcomings in clinical care were identified in 18 cases (56%) and problems in the organization of services in 22 (69%). CONCLUSIONS: (1) The model of audit piloted here was found to be highly acceptable to participants. (2) The episodes of substandard care that were uncovered provided useful opportunities to improve the future management of patients who were being prescribed methadone.