HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Harrington, M. Articles by Sensky, T. Search for Related Content PubMed Articles by Harrington, M. Articles by Sensky, T.

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

Royal College of Psychiatrists' Research Unit, 83 Victoria Street, London SW1H 0HW

Carol Paton, Chief Pharmacist

Oxleas NHS Trust

Chike Okocha, Consultant Psychiatrist and Senior Lecturer in Psychiatry

Greenwich District Hospital

Richard Duffett, Research Fellow

Royal College of Psychiatrists' Research Unit, London

Tom Sensky, Reader in Psychological Medicine

Imperial College School of Medicine

Declaration of interest

C. P. has very occasionally received speaker fees from Eli Lilly and Pfizer. Over the past year she has been involved with research projects funded by Novartis, Eli Lilly and Janssen—Cilag, but has not received any personal income from those projects. T. S. has been paid honoraria by numerous pharmaceutical companies for contributing to educational events. In 2000 he attended a meeting as a participant in an advisory board for Pfizer. The views expressed do not necessarily reflect those of the Royal College of Psychiatrists.

See editorial, pp. 401-402, and pp. 411-414 and pp. 418-420, this issue.

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.

This article has been cited by other articles:

				C. Paton, T. R. E. Barnes, M.-R. Cavanagh, D. Taylor, P. Lelliott, and the POMH-UK project team High-dose and combination antipsychotic prescribing in acute adult wards in the UK: the challenges posed by p.r.n. prescribing The British Journal of Psychiatry, June 1, 2008; 192(6): 435 - 439. [Abstract] [Full Text] [PDF]

				D. Meagher, A. Pullela, M. Meisinger, N. Geaney, and S. O'Brien Five-year follow-up of an evidence-based prescribing intervention Psychiatr. Bull., May 1, 2008; 32(5): 183 - 186. [Abstract] [Full Text] [PDF]

				G. B. K. Hung and H. K. Cheung A survey of in-patient and out-patient antipsychotic prescriptions in Hong Kong Psychiatr. Bull., March 1, 2008; 32(3): 103 - 105. [Abstract] [Full Text] [PDF]

				I. D Maidment, P. Lelliott, and C. Paton Medication errors in mental healthcare: a systematic review Qual. Saf. Health Care, December 1, 2006; 15(6): 409 - 413. [Abstract] [Full Text] [PDF]

				N. Abdelmawla and A. J. Mitchell Sudden cardiac death and antipsychotics. Part 2: Monitoring and prevention Advan. Psychiatr. Treat., March 1, 2006; 12(2): 100 - 109. [Abstract] [Full Text] [PDF]

				M. Moran, B. Raju, J. Saunders, and D. Meagher Achieving evidence-based prescribing practice in an adult community mental health service Psychiatr. Bull., February 1, 2006; 30(2): 51 - 55. [Abstract] [Full Text] [PDF]

				H. Ito, A. Koyama, and T. Higuchi Polypharmacy and excessive dosing: psychiatrists' perceptions of antipsychotic drug prescription The British Journal of Psychiatry, September 1, 2005; 187(3): 243 - 247. [Abstract] [Full Text] [PDF]

				P. Rowlands The NICE schizophrenia guidelines: the challenge of implementation Advan. Psychiatr. Treat., November 1, 2004; 10(6): 403 - 412. [Abstract] [Full Text] [PDF]

				C Paton and P Lelliott The use of prescribing indicators to measure the quality of care in psychiatric inpatients Qual. Saf. Health Care, February 1, 2004; 13(1): 40 - 45. [Abstract] [Full Text] [PDF]

				D. Meagher and M. Moran Sub-optimal prescribing in an adult community mental health service: prevalence and determinants Psychiatr. Bull., July 1, 2003; 27(7): 266 - 270. [Abstract] [Full Text] [PDF]

				C. Paton, R. Duffett, M. Harrington, P. Lelliott, C. Okocha, and T. Sensky Patterns of Antipsychotic and Anticholinergic Prescribing for Hospital Inpatients J Psychopharmacol, June 1, 2003; 17(2): 223 - 229. [Abstract] [PDF]

				S. Husain, A. Feeney, and A. Tomison Psychiatr. Bull., March 1, 2003; 27(3): 115 - 115. [Full Text] [PDF]

				D. Taylor Antipsychotic prescribing -- time to review practice Psychiatr. Bull., November 1, 2002; 26(11): 401 - 402. [Full Text] [PDF]

				P. Lelliott, C. Paton, M. Harrington, M. Konsolaki, T. Sensky, and C. Okocha The influence of patient variables on polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients Psychiatr. Bull., November 1, 2002; 26(11): 411 - 414. [Abstract] [Full Text] [PDF]

				M. Harrington, P. Lelliott, C. Paton, M. Konsolaki, T. Sensky, and C. Okocha Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients Psychiatr. Bull., November 1, 2002; 26(11): 418 - 420. [Abstract] [Full Text] [PDF]