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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.

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