Thalitaya Madhusudan Deepak, Reynolds Claire, Ismail Imadeldin
East London NHS University Foundation Trust, London, UK,
Psychiatr Danub. 2017 Sep;29(Suppl 3):578-583.
People with intellectual disabilities (ID) are prescribed antipsychotic medications for different reasons; sometimes this is for a mental illness such as psychotic or affective symptoms, however antipsychotics are also used to improve behaviours that challenge, which are common in people with intellectual disabilities (ID) or autism or both. Antipsychotic medications can have many unwanted side effects and these should be monitored for. Guidelines also indicate that reductions in medication should be considered at psychiatry reviews and alternative interventions should be trialled.
Using national recommendations on antipsychotic prescribing and monitoring and also on reducing antipsychotics in people with intellectual disabilities (ID), audit standards were determined.
The Bedford caseload included 192 service users; of these 2 were new referrals and had yet to be seen so were not included. 70 of the remaining 190 were not on an antipsychotic medication. 120 patients were on an antipsychotic medication. Medical records of 60 of these were audited against the identified standards. The records over the previous year were observed to see either how an antipsychotic was started or an existing antipsychotic was monitored compared to the standards.
智障人士因不同原因被开具抗精神病药物；有时是用于治疗精神疾病，如精神病性或情感症状，但抗精神病药物也用于改善那些具有挑战性行为，这类行为在智障人士、自闭症患者或两者兼具的人群中很常见。抗精神病药物可能会有许多不良副作用，对此应进行监测。指南还指出，在精神科复诊时应考虑减少用药，并应尝试其他干预措施。
依据关于抗精神病药物处方及监测以及减少智障人士抗精神病药物使用的国家建议，确定了审核标准。
贝德福德的病例总量包括192名服务对象；其中2名是新转诊患者，尚未就诊，因此未纳入。其余190名患者中有70名未服用抗精神病药物。120名患者正在服用抗精神病药物。其中60名患者的病历依据确定的标准进行了审核。观察过去一年的病历，以了解与标准相比，抗精神病药物是如何开始使用的，或者现有抗精神病药物是如何进行监测的。
