Hostname: page-component-f554764f5-nwwvg Total loading time: 0 Render date: 2025-04-17T04:50:35.117Z Has data issue: false hasContentIssue false
  • English
  • Français

A simple clinical audit of antipsychotic medication prescribing on Hollywell Psychiatric Intensive Care Unit (PICU)

Published online by Cambridge University Press:  13 May 2011

L Steve Choong ,
Tim Coupe  and
JayaPrabha Vijayan
L Steve Choong
Affiliation:
Consultant Psychiatrist, Hadley Unit, Newtown Hospital, Worcester, UK
Tim Coupe*
Affiliation:
Clinical Audit Facilitator, Newtown Hospital, Worcester, UK
JayaPrabha Vijayan
Affiliation:
Senior House Officer, Hillcrest, Redditch, Worcestershire, UK
*
Correspondence to: Mr Tim Coupe, 220 The Bungalow, Newtown Hospital, Newtown Road, Worcester, Worcestershire, UK WR 5 1DD. E-mail: tim.coupe@worcsmhp.nhs.uk
Get access

Abstract

Aim and method: To review antipsychotic prescribing practice using selected recommendations from the 2006 Royal College of Psychiatrists’ (RCPsych) consensus statement on the use of high dose antipsychotic medication. A clinical audit of antipsychotic prescribing for patients from two periods, February to October 2005 and February to October 2006, who were discharged from Hollywell PICU at Hillcrest and had received one or more antipsychotic medications whilst an inpatient there.

Results: The proportion of patients receiving a single antipsychotic increased from 9 (31%) in 2005 to 22 (55%) in 2006 and the proportion prescribed high dosages of antipsychotics declined, 10 (33%) in 2005 vs. 3 (8%) in 2006. The number of high dose combination prescriptions also declined, 4 (13%) in 2005 vs. 1 (3%) in 2006.

Clinical implications: The audit illustrates the potential for individual variation in prescribing practice in the PICU environment. It suggests that the Royal College of Psychiatrists’ 2006 consensus statements on antipsychotic prescribing can be used to both benchmark clinical practice and promote evidence based prescribing.

Keywords

Psychiatric intensive careanti-psychoticpolypharmacyclinical audit
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 8 , Issue 1 , April 2012 , pp. 11 - 14
Copyright
Copyright © NAPICU 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Brown, S. and Bass, N. (2004) The psychiatric intensive care unit (PICU): patient characteristics, treatment and outcome. Journal of Mental Health. 13(6): 601–609.CrossRefGoogle Scholar
Cornwall, P. L., Hassanyeh, F. and Horn, C. (1996) High dose antipsychotic medication. Improving clinical practice in a psychiatric special (intensive) care unit. Psychiatric Bulletin. 20: 676–680.CrossRefGoogle Scholar
Hillam, J. and Evans, C. (1996) Neuroleptic drug use in psychiatric intensive therapy units; problems with complying with the consensus statement. Psychiatric Bulletin. 20: 82–84.CrossRefGoogle Scholar
Jones, H., Jones, R. and Lucey, J. V. (1998) Review of College guidelines on high-dose neuroleptic use in a psychiatric intensive care unit. Psychiatric Bulletin. 22: 598–600.CrossRefGoogle Scholar
Langan, J. and Shajahan, P. (2010) Antipsychotic polypharmacy: review of mechanism, mortality and management. The Psychiatrist. 34: 58–62.CrossRefGoogle Scholar
Paton, C., Barnes, T., Cavanagh, M. R., Taylor, D. and Lelliott, P. (2008) High dose and combination antipsychotic prescribing in acute adult wards in the UK: the challenges posed by p.r.n prescribing. British Journal of Psychiatry. 192: 435–439.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (1993) Consensus Statement on the Use of High Dose Antipsychotic Medication. Council Report CR26. London: Royal College of PsychiatristsGoogle Scholar
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.Google Scholar
Royal College of Psychiatrists (2006) Consensus Statement on High Dose Antipsychotic Medication. Council Report CR138. London: Royal College of Psychiatrists.Google Scholar
Royal College of Psychiatrists (2009) Prescribing Observatory for Mental Health (POMH-UK): Topic 3: Benchmarking the prescribing of high dose and combined antipsychotics on forensic wards. http://www.rcpsych.ac.uk/pdf/POMH-UK%20Topic%203%20leaflet.pdfGoogle Scholar
Taylor, D. (2010) Antipsychotic polypharmacy – confusion reigns. The Psychiatrist. 34: 41–43.CrossRefGoogle Scholar