Impact of audit and feedback on antipsychotic prescribing in schizophrenia

No Thumbnail Available
File version
Author(s)
Wheeler, Amanda
Humberstone, Verity
Robinson, Elizabeth
Sheridan, Janie
Joyce, Peter
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2009
Size
File type(s)
Location
License
Abstract

Objective To examine the impact of audit and feedback on antipsychotic prescribing for schizophrenia outpatients over 4.5 years. Methods Clinical files in three mental health services caring for outpatients in Auckland, New Zealand were reviewed at two time-points (March 2000, October 2004). After the first audit, feedback was provided to all three services. Baseline prescribing variations between services were found for antipsychotic combinations and second-generation antipsychotic (SGA) prescribing, in particular clozapine. In two services audit and feedback continued with two interim reviews (October 2001, March 2003). Specific feedback and interventions targeting clozapine use were introduced in both services. No further audit or feedback occurred in the third service until the final audit. Data were collected (patient characteristics, diagnosis, antipsychotic treatment) and analysed at each audit. Results Three prescribing variables (antipsychotic monotherapy, SGA and clozapine use) were consistent with practice recommendations at the final audit (85.7%, 82.7% and 34.5% respectively) and had changed in the desired direction for all three services over the 4.5 years. At baseline there were differences between the three services. One service had baseline prescribing variables closest to recommendations, was actively involved in audit, and improved further. The second service, also actively involved in audit had baseline prescribing variables further from recommendations but improved the most. The service not involved in continuing audit and feedback made smaller changes, and SGA and clozapine use at endpoint were significantly lower despite at baseline being comparable to the service which improved the most. Conclusions This study found audit and feedback to be an effective intervention in closing the gap between recommended and routine clinical practice for antipsychotic prescribing in schizophrenia.

Journal Title

Journal of Evaluation in Clinical Practice

Conference Title
Book Title
Edition
Volume

15

Issue

3

Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject

Public Health and Health Services not elsewhere classified

Public Health and Health Services

Persistent link to this record
Citation
Collections