Prescribing
Antipsychotic management in general practice - ensuring the right monitoring and facilitating deprescribing where possible
https://bjgp.org/content/early/2024/11/25/BJGP.2024.0367
A serial cross-sectional study using general practice and hospital data in Wales from 2011-2020, investigated trends in antipsychotic management in general practice, and the proportions of adults prescribed antipsychotics receiving psychiatrist review.
The study found that long-term antipsychotic use is increasing, with more patients managed by GPs without psychiatrist review and not on monitored disease registers.
The prevalence of adults prescribed long-term antipsychotics increased from 1.055% (95% confidence interval [CI] = 1.041 to 1.069) in 2011 to 1.448% (95% CI = 1.432 to 1.464) in 2020. The proportion receiving annual psychiatrist review decreased from 59.6% (95% CI = 58.9 to 60.4) in 2011 to 52.0% (95% CI = 51.4 to 52.7) in 2020. The proportion on the serious mental illness (SMI) register also decreased.
Suggested WiseGP Actions
At annual medication reviews, check patients prescribed antipsychotics are on an appropriate SMI register and have had cardiometabolic monitoring. Alternatively, a search could be performed to identify everyone prescribed an antipsychotic, to prompt appropriate coding onto an SMI register and monitoring.
Use medication reviews as an opportunity to optimise management, or deprescribe antipsychotics if possible, seeking specialist advice as required.
Read more about the research informing this GEM: https://bjgp.org/content/early/2024/11/25/BJGP.2024.0367
