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The impact of a change in prescribing policy on antipsychotic prescribing in a general adult psychiatric hospital

Published online by Cambridge University Press:  09 May 2014

J. Kelly ,
F. Kelly ,
K. Santlal  and
S. O’Ceallaigh
J. Kelly*
Affiliation:
Psychiatry Lecturer, Department of Psychiatry, Cork University Hospital, Dublin, Ireland
F. Kelly
Affiliation:
Clinical Lecturer, Trinity College & Senior Registrar, Our Lady’s Hospital Navan, Dublin, Ireland
K. Santlal
Affiliation:
Registrar, St. Patrick’s University Hospital, Dublin, Ireland
S. O’Ceallaigh
Affiliation:
Consultant Psychiatrist, St. Patrick’s University Hospital, Dublin, Ireland, Ireland
*
Address for correspondence: J. Kelly, Psychiatry, Cork University Hospital, Psychiatry Department, Cork University Hospital, Cork, Co. Cork, Ireland. (Email: kellyjr@tcd.ie)
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Abstract

Objectives

To examine the impact of a change in local prescribing policy on the adherence to evidence-based prescribing guidelines for antipsychotic medication in a general adult psychiatric hospital.

Methods

All adult in-patients had their clinical record and medication sheet reviewed. Antipsychotic prescribed, dose prescribed and documented indications for prescribing were recorded. This was done before and after the implementation of the change in hospital antipsychotic prescribing policy.

Results

There were no significant differences in age, sex, Mental Health Act status, psychiatric diagnosis or documented indications for prescribing multiple or high dose antipsychotics between the two groups. There was an increase in the preferential prescribing of multiple second-generation antipsychotics (p=0.01) in the context of a significant reduction in the prescribing of multiple antipsychotics overall (p=0.02). There were no significant reductions in prescribing of mixed generations of antipsychotics (p=0.12), high dose antipsychotics (p=1.00) or as required (PRN) antipsychotics (p=0.74).

Conclusions

Changes in local prescribing policy can improve adherence to quality prescribing guidelines and cause clinically significant improvements in patterns of prescribing in a general adult psychiatric hospital.

Keywords

Antipsychotic agentsclinical auditinappropriate prescribingphysician prescribing patternsschizophrenia
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 3 , September 2014 , pp. 167 - 173
Copyright
© College of Psychiatrists of Ireland 2014 

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