EPA-0429 – Psychotropic Prescribing Patterns in English Prisons: A Cross-sectional Study

Abstract

Introduction:

Psychotropic medicines are widely used to treat mental illness in the community. In prisons, however, the equity, continuity and appropriateness of prescribing for mentally ill prisoners have been questioned. Currently, there are no robust data regarding prescribing patterns in English prisons; yet these are essential to managing the overall clinical, cost effective, and safe use of medicines.

Aim:

We aimed to investigate patterns of psychotropic medication prescribing in English prisons.

Objectives:

• To establish psychotropic prescribing rates in prisons.

• To compare prison psychotropic prescribing patterns with the wider community.

• To gain insight into staff and patient perspectives on psychotropic prescribing in prisons.

Methods:

We conducted a cross-sectional survey of 12 prisons to generate prescribing rates for antidepressants, antipsychotics, hypnotic/anxiolytics and/or central nervous system stimulants (chapters 4.1–4.4 of the British National Formulary). On census days, we used clinical records to collect demographic, clinical and prescription data on all patients in receipt of psychotropic medication. Equivalent data on community-based patients were supplied by the UK General Practice Research Database for comparison purposes. Qualitative interviews were completed with 16 members of staff and 17 patients and analysed thematically.

Results and Conclusions:

This presentation will describe the rates, types and doses of medicines prescribed in prisons to treat mental illness. Appropriate community comparisons will be made, accounting for demographic and clinical characteristics. Staff and patient perspectives will be explored. Implications for patient safety, equivalence and appropriateness of prescribing will be discussed.