An Audit of the Prescribing and Monitoring of Antipsychotic Medication in an Older Adult Inpatient Psychiatric Ward Using NICE Guidance [CG178] Psychosis and Schizophrenia in Adults: Prevention and Management

• DOI: 10.1192/bjo.2024.554
• Publication Date: 2024-08-01T10:05:53Z
• Authors: Alaa Shabaka; Thomas Parry; Mary Ugah; Stephen De Souza
• Keywords: Nice; Relapse prevention; Management of schizophrenia

Aims The National Institute for Health and Care Excellence (NICE) offers guidance prescribing monitoring of antipsychotic medications. In this audit we sought to investigate if our unit was compliant with guidance. Methods carried out on a 28 bedded older adult inpatient psychiatric unit. notes all patients admitted ward 27/11/2023 were reviewed. Any patient an included in the audit. Four standards reflecting antipsychotics identified. These were: 1.3.5.1 choice medication should be made by service user healthcare professional together, taking into account views carer agrees. 1.3.6.1 Before starting medication, undertake record baseline investigations. 1.3.6.2 offer person psychosis or schizophrenia electrocardiogram (ECG). 1.3.6.3 Treatment considered explicit individual therapeutic trial. 1.3.6.4 Monitor following (response treatment – side effects adherence physical health) regularly systematically throughout treatment. five areas broken down 22 domains which are outlined results below. Results Of ward, medication. 1.3.5.1: Medication benefits discussed documented 9/19 cases (47%), 3 refusing engage discussion. Side 5/21 (23%). 1.3.6.1: Patients underwent range some cases, hadn't been long enough require additional tests. Some excluded as they refused testing. Glycosylated Haemoglobin (100%), Weight Pulse Blood Pressure Lipid Profile (86%), Prolactin Levels (77%), Assessment nutritional status, diet fasting blood glucose (38%), Level Physical Activity (31%), any movement disorder (22%), Waist Circumference (0%). 1.3.6.2: An ECG offered 94% cases. 1.3.6.3: rationale continuing, changing stopping recorded 86% no had doses above BNF maximum. 1.3.6.4: Overall health monitoring, weekly weights and, pulse BP at 12 weeks (100%). Adherence response both 95%. Measurement glycaemic control (57%), disorders (14%) (13%). Conclusion While there good practice, number significant omissions. Remedies these deficits will proposed.