Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients.
The development of atypical antipsychotics has not only given the prescriber more options, but also increased the complexity of decision making. We examined current prescribing practice for antipsychotic and anticholinergic drugs, which involved a 1-day census of all antipsychotic and anticholinergic drugs prescribed for 4191 inpatients in 49 UK mental health services. Eighty-five percent of inpatients were prescribed antipsychotics, 48% of whom were prescribed more than one. Atypical antipsychotics were widely prescribed and combined with typicals in over 60% of cases. Large doses of antipsychotics were frequently prescribed 'as required'. The dose administered was always much less than the dose prescribed and nothing at all was administered against 79% of prescriptions. Antipsychotic prescribing often deviates from recommended practice. Nursing staff have considerable discretion to administer large doses of antipsychotics on an 'as required' basis.
Paton
Carol
C
Oxleas NHS Trust, Pinewood House, Dartford, Kent, UK. carol.paton@oxleas.nhs.uk
Lelliott
Paul
P
Harrington
Maria
M
Okocha
Chike
C
Sensky
Tom
T
Duffett
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D009732:Nursing Care / Q000592:standards; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D006113:United Kingdom
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists