The Pharmaceutical Journal
Vol 270 No 7238 p301
1 March 2003

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Letters to the Editor

Antipsychotics

Multidisciplinary approach is needed to prescribing

From Mr L. Furniss, MRPharmS

It pained me to read your news item on poor prescribing of antipsychotics in nursing homes (PJ, 15 February, p214). Studies over the past decade have illustrated this problem, with no apparent improvement.^1,2 Even if the community pharmacist's contract involved a clinical component, I wonder if this type of intervention would be beyond the current competence of most community pharmacists. Much of this prescribing is done by secondary care specialists hence the need for interventions to span the primary-secondary care interface. Pressure from the homes themselves on the general practitioner to prescribe some tranquillisation is another factor to contend with.

Clearly there is no easy solution to this problem and the situation does not seem to be improving despite increased awareness. Future studies in this area should stop collecting data only and look at novel interventions to improve the situation. Perhaps a more multidisciplinary approach is needed. Unfortunately the intervention in our study2 did not look objectively at any change in the use of these drugs specifically. Subjectively, though, interventions on psychiatric prescriptions were much more difficult to resolve with prescribers than those concerning physical medicines.

I would hate to think that when my time comes to enter a nursing home that we are still quoting the figures described in your news item. These vulnerable members of the population deserve better.

Lee Furniss
London N16

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