scholarly journals Polypharmacy and high-dose antipsychotic regimes in the community

2010 ◽  
Vol 34 (2) ◽  
pp. 44-46 ◽  
Author(s):  
Tongeji E. Tungaraza ◽  
Seema Gupta ◽  
Jane Jones ◽  
Rob Poole ◽  
Gary Slegg
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Atypical Antipsychotics ◽  
Case Note ◽  
Clinical Implications ◽  
High Dose ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Standing Problem

Aims and methodTo determine the pattern of psychotropic prescribing in a group of people with psychosis who were living in the community under community mental health team (CMHT) care. Case-note entries over the previous 12 months were examined.ResultsOnly a third of individuals were on one psychotropic medication. Atypical antipsychotics were prescribed to 80.6%. Polypharmacy was common. A third of people were taking three or more psychotropic drugs and 13.7% were on high-dose regimes, mostly involving two atypical antipsychotics.Clinical implicationsThe use of atypicals has not eliminated polypharmacy or high-dose antipsychotic regimes. Clinicians need to be aware of this long-standing problem.

scholarly journals A follow-up study of the use of a patient-held record in mental health

2002 ◽  
Vol 26 (3) ◽  
pp. 91-92 ◽  
Author(s):  
A. Stafford ◽  
R. Laugharne ◽  
K. Gannon
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Pilot Project ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Follow Up Study ◽  
The Past

Aims and MethodPatient-held records have been introduced in mental health over the past 2 decades. This follow-up study aimed to evaluate one pilot project 5 years after the records were introduced. All patients initially interviewed 4 years previously were approached and asked about their use and opinion of the record.ResultsOf the 19 people interviewed, 12 were still using the record and had a positive opinion of its usefulness. Of all community mental health team contacts, 72% were recorded in the patient-held notes.Clinical ImplicationsPatient-held records are sustainable in a naturalistic clinical setting over the period of 5 years.

scholarly journals Prescribing and monitoring high dose and combined antipsychotics in community mental health team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S175-S175
Author(s):  
Dipanjan Banerjee ◽  
Tracey Green ◽  
Umama Khan
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Maximum Dose ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Antipsychotic Medications ◽  
Health Team ◽  
Regular Monitoring

AimsThe aim was to establish the prevalence of prescription of combined and high dose antipsychotics in the community mental health team and to see if such patients were being offered regular monitoring as advised by NICE guidelines.BackgroundThe use of high dose antipsychotic treatment (HDAT) should be in line with the recommendations of the Royal College of Psychiatrists Consensus statement on high dose antipsychotic Treatment. Such treatment should be initiated only when standard treatments have failed. As high dose prescribing of antipsychotic medications can potentially harm than benefit causing serious side effects and sudden death. Close monitoring and documentation are required. Also, reviewing these patients at regular intervals is recommended.MethodA retrospective audit of 50 case notes of patients currently on antipsychotics was done. Case notes were selected randomly from a pool of 300 plus patients under the care of Isle of Wight NHS Trust in the HoNos Cluster 11 and 12 care pathways. Data were gathered on patients` demographics, diagnosis, medication monitoring. Data were analysed and discussed with consultant psychiatrist and senior mental health pharmacist. Patients who were not on any antipsychotic medications were not included in the audit.Result90% of the patients were on single antipsychotic (45 out of 50), 4.45% (2 out of 45)were above BNF recommended dose. 10% (5) patients were prescribed combined antipsychotics. 40% (2)of them were above BNF recommended maximum dose. A total of 8% (4 out of 50) patients were on above BNF recommended maximum dose. All the patients on high dose antipsychotics had a clear plan documented in the system. Documented monitoring of Full blood count was found in 75%, blood glucose in 50%, lipid in 75%, cardiac monitoring (Electrocardiogram or ECG) in 0%, physical health monitoring in 0%ConclusionAs far as we know, this is the first time an audit has been done on the patients under the Community Mental Health Team on high dose antipsychotic treatment. The data showed areas of good practice as the majority of the patients were on monotherapy, and all the patients on a high dose or combined antipsychotics had clear management plans outlined in their notes. However, the audit also highlighted areas that currently need improvements such as regular monitoring of the patients on high dose and combined antipsychotics. It should also be clearly documented, recorded, and reviewed at six-monthly intervals.

scholarly journals Liaison-consultation meetings in general practice

1999 ◽  
Vol 23 (3) ◽  
pp. 161-164 ◽  
Author(s):  
Rebecca J. Tipper ◽  
Ian M. Pullen
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Community Mental Health ◽  
Information Exchange ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Audio Recordings ◽  
Shared Information

Aims and methodAudio-recordings were made over a period of six months of liaison–consultation meetings between general practitioners and a community mental health team in the Scottish Borders to show general trends in length of discussion and information exchange.ResultsMeetings were predominantly supportive, with high levels of shared information, but little educational content. Some trends in discussion time are shown.Clinical implicationsAudio-recording could form the basis for reviewing the function of liaison-consultation meetings.

scholarly journals Improving methods of assessment in a community mental health team

1996 ◽  
Vol 20 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Adrian Treloar
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Clinical Information ◽  
The Elderly ◽  
Case Note ◽  
Dramatic Improvement ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Changing methods of recording psychiatric histories by a community mental health team for the elderly was associated with a dramatic improvement in the quality of recording of clinical Information and of communication with general practitioners. Comparison is made with published studies of case note audit with feedback. It is suggested that restructuring the way we work may be more effective than simple review of case notes with feedback.

scholarly journals Use of psychotropic medication among psychiatric out-patients with personality disorder

2010 ◽  
Vol 34 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Elena Baker-Glenn ◽  
Mark Steels ◽  
Chris Evans
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Community Mental Health ◽  
Psychotropic Medication ◽  
Primary Diagnosis ◽  
Total Annual Cost ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team

Aims and methodThis survey was conducted to ascertain the use of psychotropic medication in the treatment of patients with a primary diagnosis of personality disorder within a community mental health team. A sample of 113 patients were identified, their notes were reviewed, and details of current medications and diagnoses recorded.ResultsFour-fifths of patients were prescribed at least one psychotropic medication. The most commonly prescribed medication class was antidepressant, comprising almost half of prescriptions. The total annual cost across 107 patients was £37 000.Clinical implicationsMedication is commonly prescribed to people with personality disorder but more needs to be known about why prescriptions are started and stopped, what the benefits are, and how these are judged by patients and care teams.

scholarly journals To improve the communication between a community mental health team and its service users, their families and carers

2020 ◽  
Vol 9 (4) ◽  
pp. e000914
Author(s):  
Priyalakshmi Chowdhury ◽  
Amir Tari ◽  
Ola Hill ◽  
Amar Shah
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
User Satisfaction ◽  
Service User ◽  
Service Users ◽  
Not Given ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Specialist Registrar ◽  
Health Team

This article describes the application of quality improvement (QI) to solve a long-standing, ongoing problem where service users or their carers felt they were not given enough information regarding diagnosis and medication during clinic assessments in a community mental health setting. Service users and carers had shared feedback that some of the information documented on clinic letters was not accurate and the service users were not given the opportunity to discuss these letters with the clinician. The aim of this QI project was to improve the communication between the community mental health team (CMHT) and service users and their carers. Wardown CMHT volunteered to take on this project. The stakeholders involved were the team manager and deputy manager, the team consultant, the team specialist registrar, team administrative manager, two carers and one service user. The project had access to QI learning and support through East London NHS Foundation Trust’s QI programme. The team organised weekly meetings to brainstorm ideas, plan tests of change to review progress and to agree on the next course of action. The outcome was an increase in service user satisfaction from 59.9% to 78% over a period of 6 months, and a reduction in complaints to zero.

Sign in / Sign up

Export Citation Format

Share Document