Why the study?
What factors are associated with high dose neuroleptic prescription in psychiatric in-patients?
What factors are associated with high dose neuroleptic prescription in psychiatric in-patients?
High neuroleptic prescription is driven more by a patient's past history of aggression and prescriber habits than by current behavior.
May prompt caution in relying on aggression history for dosing; leaves open whether prospective data should guide practice over prescriber habits.
Aims and Method Neuroleptic medication is often used in excess of the BNF maximum. The purpose of this study was to examine the relationship of neuroleptic dose to patient, prescriber and environmental factors, by using a cross sectional ‘snapshot’ study of psychiatric in-patient prescriptions combined with a retrospective case note survey. Results It was found that certain consultants prescribe higher doses of neuroleptics than others. Patients with a history of aggression had a nine and a half times higher chance of being prescribed higher doses of neuroleptics. Patients with a greater than 5-year history of neuroleptic prescription received higher doses. Clinical Implications High neuroleptic prescription is related more to patients' past reputation and prescriber differences than to patients' current behaviour.
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Wilkie et al. (2001) studied this question.
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