EPA-0680 - Towards Collaborative Intervention that Improves the Lives of Patients with Schizophrenia: Clinicians as Drivers of Policy Change

Abstract

An evidence-based, integrated care package that addresses mental and physical health needs would help to transform the lives of people with schizophrenia. It should be underpinned with a co-ordinated approach by healthcare professionals and supported by the national healthcare system and by educational and research facilities. Collaboration between relevant stakeholders at national and local level is required to achieve this.

The UK Prescribing Observatory for Mental Health (POMH-UK), based at the Royal College of Psychiatrists within the College Centre for Quality Improvement, illustrates one such collaboration. POMH-UK facilitates national, audit-based, quality improvement programmes (QIPs) that address the use of medicines in psychiatric practice. Since POMH-UK began in 2005, it has initiated QIPs addressing several topics relevant to the treatment of schizophrenia, including the use of high-dose and combined antipsychotics in acute adult inpatient and forensic settings, screening for the metabolic side effects of antipsychotics, the quality of assessment of side effects in patients treated with depot/long-acting injection antipsychotics, and medicines reconciliation at the point of hospital admission.

Positive change in prescribing practice in psychiatric services has been achieved for many of these QIPs, although progress is gradual and gains are generally modest. Key elements of the QIPs are feedback of benchmarked performance for local clinical reflection and customised change interventions informed by the national audit findings and parallel qualitative work. The benefits and drawbacks of such an approach will be discussed, in the context of schizophrenia, with a view to evolving a model that other countries might replicate.