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CP-121 Adverse drug reactions from antipsychotics contributing to admissions in an acute general hospital
  1. J Brooks1,2,
  2. C Schneider3,
  3. K Wilson4,
  4. M Hashmi5,
  5. B Hebron4
  1. 1Aston University, Life and Health Sciences, Birmingham, UK
  2. 2Sandwell and West Birmingham NHS Trust, Pharmacy, Birmingham, UK
  3. 3University of Sydney, Pharmacy, Sydney, Australia
  4. 4Aston University, Life and Health Sciences, Birmingham, UK
  5. 5Birmingham and Solihull NHS Foundation Trust, RAID City Hospital, Birmingham, UK

Abstract

Background Antipsychotic medicines are associated with an increased risk of falls, delirium, cerebrovascular and cardiovascular fatalities.1 These adverse drug reactions (ADRs) have a negative impact on patient quality of life and are often implicated in hospital admissions; as such they can be a significant burden on health services.2

Purpose To investigate how adverse drug reactions (ADRs) from antipsychotic medicines may contribute to admission in an acute general hospital.

Material and methods We undertook a prospective study of all patients in our institution who were prescribed antipsychotics. Patients were identified from real-time dispensing information which was used by a specialist pharmacist to drive a ward-based clinical pharmacy review. If an ADR was suspected, consent was gained and a referral to the liaison psychiatric team generated. Results were recorded in line with national [Caldicott] ethical guidelines.

Results During the study period (17/09/2012 to 28/10/2013), 312 patients prescribed antipsychotic medicines were admitted. Thirty-one patients (10%) were referred due to concerns over ADRs, the majority of which (24, 77%) were generated by the specialist pharmacist (figure 1). Following referral, 21 of the 31 patients had their antipsychotic drug altered. It was stopped in 11 patients and doses reduced in a further 10.

Conclusion An admission-related ADR was identified in 10% of the patients prescribed antipsychotic medicines. The pharmacist was pivotal in this process and detected the majority. Early identification and psychiatric referral is essential to facilitate a decision that balances the patients’ mental and physical health needs. Pharmacists working in the acute sector should be mindful that antipsychotic medicines may contribute to admissions. A close relationship with psychiatric services can facilitate medicines review and prevent harm.

References and/or Acknowledgements

  1. BMJ Group and Pharmaceutical Press. British National Formulary; 68, 2014

  2. Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18,820 patients. BMJ 2004;329(7456):15–19

References and/or AcknowledgementsNo conflict of interest.

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