Naturalistic study of the antipsychotic medication review service at the Maudsley Hospital

Abstract

Aims and method: To evaluate the effectiveness of the antipsychotic medication review service (AMRS) at the Maudsley Hospital. Patient notes were analysed from the AMRS and estimates of Global Assessment Scale (GAS) scores were made from entries in the notes. Data on hospital admissions before and during attendance at the AMRS were obtained from the trust-wide computerised patient administration system. Results: A statistically significant improvement in GAS scores was seen for patients who stayed in contact with the AMRS. Patients who did not respond to the first atypical drug often made a good response to an alternative atypical antipsychotic. Patients attending the AMRS had fewer hospital admissions than they did before attendance, although this was not statistically significant. Clinical implications: Although more expensive on a dose-by-dose rate, atypical antipsychotics may be cost effective by improving compliance and reducing the number of relapses and hospital admissions. Specialised services with frequent patient contact can be effective in preventing relapse and improving global function.