Re-Audit of Prescribing Responsibility for Antipsychotic Depots for Shared Care Patients(PRAD-SCP)

AIMS: To re-audit whether community teams are requesting GPs to take over the prescribing of antipsychotic depots for patients who have been stabilised on treatment, in line with Shared Care Pathway protocols by Greater Manchester Medicines Management Group (GMMMG). METHODS: The sample size was 199 patients open to Rochdale, Heywood and Middleton community mental health team antipsychotic depot clinics. Information was gathered from depot cards, care records and clinical entries on Paris and imputed on an Excel spreadsheet. This was a prospective audit and data collection took place between 01/11/22 and 30/12/22 by the auditors. Microsoft Excel was used to carry out simple percentage analysis by the authors and presented using charts. RESULTS: Transfer of prescribing responsibility for first generation antipsychotic had the highest compliance rate with 98% prescribed by GP on shared care protocol for stable patients followed by Paliperidone and Risperidone at 94%. Aripiprazole was the least compliant with 91% prescribed by GP for stable patients as against 100% target. Overall compliance rate for all depot antipsychotics was 96% compared with 83% from original audit in 2020. In comparing the different community teams, one team was compliant by 99% overall in transferring prescribing responsibility to the GP for stable patients and 100% compliant with 1st generation antipsychotics, paliperidone and risperidone. The data showed that CMHT prescribed higher proportion of 2nd generation antipsychotics when compared to original audit. CONCLUSION: This re-audit has demonstrated that overall, there was significant improvement in compliance with GMMMG shared care guidelines by Rochdale community teams from 83% in 2020 to 96% in 2022. However, this does not meet the standard of 100% target for depot antipsychotics as per GMMMG guidelines. In other to ensure that target standards are met a 100%, secondary care prescribers should ensure appropriate transfer of prescribing responsibilities via the shared care protocol to the GP for stable patients are done and also shared with the new team particularly during the transition phase for patients transferred from one team to another who are stable on their current medication.