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The results of a multi-centre audit of the prescribing of antipsychotic drugs for in-patients in the UK

  • Maria Harrington (a1), Paul Lelliott (a2), Carol Paton (a3), Chike Okocha (a4), Richard Duffett (a5) and Tom Sensky (a6)...
Abstract
Aims and Method

Forty-seven UK mental health services participated in a 1-day audit of prescribing of antipsychotic drugs. Audit standards were derived from national guidelines and consensus statements.

Results

Of the 3132 patients, 20% were prescribed a total dose of antipsychotic medication above that recommended by the British National Formulary. The majority of case notes failed to record an indication for high-dose prescribing or that the patient had been informed; only 8% had undergone an electrocardiogram. Forty-eight per cent of patients were prescribed more than one antipsychotic drug.

Clinical Implications

Antipsychotic prescribing for in-patients often runs counter to existing guideline recommendations. It is likely that many patients who are prescribed high doses or polypharmacy are unaware that their prescription is out of line with guideline recommendations and is inadequately monitored.

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Copyright
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.
References
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American Psychiatric Association (1997) Practice guidelines for the treatment of patients with schizophrenia. American Journal of Psychiatry, 154, 4 (suppl.).
Brabbins, C., Butler, J. & Bentall, R. (1996) Consent to neuroleptic medication for schizophrenia: clinical, ethical and legal issues. British Journal of Psychiatry, 168, 540544.
Bradley, J. J. (1997) Litigation against psychiatrists. Psychiatric Bulletin, 21, 321322.
British Medical Association & Royal Pharmaceutical Society of Great Britain (1999) British National Formulary. London & Wallingford: BMJ Books & Pharmaceutical Press.
Chaplin, R. & Mcguigan, S. (1996) Antipsychotic dose: from research to clinical practice. Psychiatric Bulletin, 20, 452454.
Department of Health (1998) Health and Personal Social Services Statistics for England, 1997 Edition. London: The Stationery Office.
EPPIC Statewide Services (1999) The Australian Clinical Practice Guidelines for Early Psychosis. Victoria, Australia: EPPIC Statewide Services.
Henderson, T., Gallagher, D. & Stark, C. (1997) A survey of the use of the electrocardiogram in psychiatry. Psychiatric Bulletin, 21, 136138.
Krazucki, C. & Mcfarlane, F. (1996) Electrocardiograms, high-dose antipsychotic treatment and College guidelines. Psychiatric Bulletin, 20, 326330.
Milton, J., Lawton, J., Smith, M., et al (1998) Hidden high-dose antipsychotic prescribing: effects of p.r.n. doses. Psychiatric Bulletin, 22, 675677.
Newton, K. L., Murthy, R. & Qureshi, J. (1997) Antipsychotic prescribing in the light of the consensus statement of the College. Psychiatric Bulletin, 21, 408410.
New Zealand Ministry of Health (1996) Guidelines for Prescribing Psychotropic Drugs. New Zealand: Wellington.
Royal College of Psychiatrists (1993) Consensus Statement on the Use of High DoseAntipsychotic Medication. Council Report CR26. London: Royal College of Psychiatrists.
Royal College of Psychiatrists (1997) The Association between Antipsychotic Drugs and Sudden Death. Report of the Working Group of the Royal College of Psychiatrists' Psychopharmacology Sub-Group. Council Report CR57. London: Royal College of Psychiatrists.
Tyson, P. J., Mortimer, A. M. & Wheeler, J. A. (1999) High-dose antipsychotic treatment in clinical practice: a review, audit and survey of consultant psychiatrist opinions. Psychiatric Bulletin, 23, 661664.
Warner, J. P., Slade, R. & Barnes, T. R. E. (1995) Change in neuroleptic prescribing practice. Psychiatric Bulletin, 19, 237239.
Warner, J. P., Gledhill, J. A., Connell, F., et al (1996) How well do psychiatric trainees interpret electro-cardiographs. A cross-sectional survey. Psychiatric Bulletin, 20, 651652.
Working Group for the Canadian Psychiatric Association and the Canadian Alliance for Research on Schizophrenia (1998) Canadian Clinical Practice Guidelines for the Treatment of Schizophrenia. Canadian Journal of Psychiatry, 43(Suppl. 2).
Yorston, G. & Pinney, A. (1997) Use of high dose antipsychotic medication. Psychiatric Bulletin, 21, 566569.
Yorston, G. & Pinney, A. (2000) Chlorpromazine equivalents and percentage of British National Formulary maximum recommended dose in patients receiving high-dose antipsychotics. Psychiatric Bulletin, 24, 130132.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The results of a multi-centre audit of the prescribing of antipsychotic drugs for in-patients in the UK

  • Maria Harrington (a1), Paul Lelliott (a2), Carol Paton (a3), Chike Okocha (a4), Richard Duffett (a5) and Tom Sensky (a6)...
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