Prescribing quality improvement: reducing high-dose antipsychotic use

Abstract

Evidence of efficacy for high-dose antipsychotic therapy (HDAT) and antipsychotic combinations (AC) is lacking, while evidence of harm is compelling. Significantly higher proportions of Norfolk and Suffolk NHS Foundation Trust (NSFT) patients were being prescribed HDAT and AC compared with the national averages. Here, the authors describe a quality improvement program to rationalise and reduce HDAT and AC prescribing in NSFT, to bring it in line with, or below, the national average. The initiative demonstrates that prescribing culture can be improved through a sustained multi-professional team approach involving education and training, a targeted campaign, a proactive clinical pharmacy team and pharmacists' support.