Antipsychotic Use in Community Mental Health Service

Background: The use of antipsychotic medication remains an essential treatment modality for schizophrenia and related psychosis. However, there is a globally recognised variation in prescribing which is attributed to multiple factors. Guidelines set the expected standard and criteria for evidence based prescribing practice of antipsychotic medication. The aim of this clinical audit was to review antipsychotic prescribing patterns in adult patients with a history of schizophrenia or related psychosis attending community outpatients’ clinics and to verify the uniformity of this prescribing with clinical guideline recommendations. Methods: Information about the use of antipsychotic medication was collected in a sample of a 100 patients with a history of psychosis in Waikato region to investigate the consistency of antipsychotic medication prescribing practice using standard guidelines. Identifying inconsistent patterns of prescribing will offer opportunities for intervention and advancement of best and safe practice. Results: Most patients (86%) were maintained on a single antipsychotic medication within the recommended dose range. 27% of the patients were prescribed clozapine alone or in combination with other antipsychotic medication making clozapine the most frequently prescribed antipsychotic medication in our sample. Nearly half of the patients (48%) were on depot antipsychotic injections of which 20% were first-generation antipsychotic injections. Conclusions: Prescribing patterns of antipsychotics amongst our group of patients seem to be consistent with current evidence-based guidelines particularly with regards to class, frequency and dose range. Further research is required to assist in the formulation of Clozapine augmentation evidence-based guidelines.