Mental health in-patient services are under increasing strain worldwide. The prevalence of symptoms of Severe Mental Illness (SMI), which includes schizophrenia, schizoaffective disorder, bipolar disorder and severe affective disorders is increasing globally. For example, in 2000, 7.9% of adults in England over the age of 16 years had symptoms of SMI, compared with 9.3% in 2014(1). Patients with SMI who are admitted to long-term care psychiatric facilities are usually in a challenging and enduring stage of their illness and are prescribed complex medication regimens to manage their symptoms. Irrespective of the type of SMI patients have, those with any SMI have a mortality rate 2-3 times higher than those without a SMI, 60% of which is due to physical illness, individual lifestyle choices, psychiatric symptoms and adverse effects of psychotropic medicines (2).
Psychotropics include antipsychotics, antidepressants, anxiolytics, hypnotics and mood stabilisers and are the mainstay of treatment for SMI. They are associated with significant medication errors and adverse drug events (ADEs)(3). A systematic review of the frequency and nature of ADEs in mental health hospitals found that the rate of ADEs ranged from 10.0 to 42.0 per 1000 patient-days. The ADEs were rated as clinically significant (66.0-71.0%), serious (28.0-31.0%), or life threatening (1.4-2.0%)(3).
This study aims to describe the prescribing patterns of all medicines, including ‘as required’ (PRN) psychotropic medicines in a long-term care psychiatric facility in Ireland. Medications prescribed will be assessed for appropriateness in conjunction with patients’ clinical diagnoses. Data will be used to inform prescribing improvement.
