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Monitoring patients on high-dose antipsychotics

Published online by Cambridge University Press:  02 January 2018

Joan M. Barber ,
Jennifer Connaughton  and
Morag Wright
Joan M. Barber
Affiliation:
Department of Psychiatry, Southern General Hospital, Glasgow
Jennifer Connaughton*
Affiliation:
Pharmacist, The State Hospital Carstairs, Lanark, Scotland ML11 8RP
Morag Wright
Affiliation:
Pharmacist, The State Hospital Carstairs, Lanark, Scotland ML11 8RP
*
∗Correspondence
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Abstract

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Aims and method

Following the publication of the 1994 Consensus Statement on the use of high-dose antipsychotic medication, we identified our high-dose patients and undertook an audit of the recommended physical investigations. The patients were identified by scrutiny of prescription records. Data were collected retrospectively at six-monthly intervals for four audit cycles. Results were fed back to clinicians at the hospital journal club.

Results

The percentage of patients identified in the high-dose category fell from 35 to 23% over 18 months. Electrocardiograph monitoring of the group increased from 5 to 63%. Other tests showed a similar improvement. A very small number of abnormal results was shown. There were no untoward cardiac events.

Clinical implications

Introduction of the standards of physical monitoring advised in the Consensus Statement has implications of cost to the NHS to be balanced against risk avoidance for patients. The number of abnormalities detected in our population was low. Changing prescribing behaviour in response to reported abnormal findings proved unexpectedly slow and a new system was required.

Type
Original Papers
Information
Psychiatric Bulletin , Volume 22 , Issue 11 , November 1998 , pp. 671 - 674
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1998 The Royal College of Psychiatrists

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