Monitoring of Physical and Mental Health in Secondary Care Services Following Initiation of Antipsychotic Medications.

Abstract

Aim

To assess the monitoring of antipsychotic medication in secondary care services in accordance with The National Institute for Health and Care Excellence (NICE) guidelines¹.

Background

Recent NICE guidelines on Psychosis and schizophrenia in adults¹state that the secondary care team should monitor patients' physical health and the effects of antipsychotic medication for at least 12 months or until the person's condition has stabilised, and thereafter consider shared care with Primary care.

Methods

The electronic database generated a sample of 30 new service users attending a local community team in Solihull, UK who were initiated on antipsychotics between January 2012 and March 2013. We analysed electronic documentation according to an audit tool developed by our Trust Clinical Pharmacist, based on NICE guidelines.

Results

Results showed that 83% of patients were monitored for over 12 months or until stabilised. Other documentations included response to treatment and side effects of treatment (96.7%), emergence of movement disorders (36.7%), adherence to treatment (86.7%) and physical health (90%).

Conclusions

Most patients were followed up for their mental health. Documentation and/or specific monitoring of physical health parameters as detailed in the guidelines remained less than 30%. Similarly, the emergence of movement disorders was infrequently recorded. Training is required to improve the understanding of the importance of monitoring of physical health in individuals with psychosis or schizophrenia, especially those taking antipsychotics. Re-audit to follow.

[1] NICE. NICE guideline on Psychosis and schizophrenia in adults: treatment and management, CG178: February 2014. http://www.nice.org.uk/guidance/CG178/chapter/1-Recommendations.