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Prescribing in schizophrenia. Evaluating the effect of introducing a new treatment protocol

Maudsley Hospital, Denmark Hill, London SE5 8AF

Robert Kerwin, Professor of Clinical Neuropharmacology

Institute of Psychiatry, London

AIMS AND METHOD

To develop and introduce a drug treatment protocol for schizophrenia and to evaluate its effect on prescribing. Prescribing of antipsychotics was audited in January 1998. A prescribing protocol was then developed by a collaborative process involving all medical staff, and introduced in September 1998. A second prescribing audit was conducted in February 1999.

RESULTS

The proportion of patients prescribed atypical drugs increased from 16.6% to 25.5%. Co-prescription of atypical and typical drugs was relatively uncommon compared with findings of other prescribing surveys. The use of anticholinergic medication was significantly more likely in patients receiving regular typical drugs alongside atypical agents than in those receiving atypicals alone.

CLINICAL IMPLICATIONS

Widely agreed prescribing protocols may promote improved prescribing practices. Co-prescription of atypical and typical drugs should be discouraged.

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