CLINICAL staff should receive training about the appropriate use of mood-altering drugs on dementia patients after an audit report discovered “inadequate” documentation of prescribing reasons in the General Hospital.
Psychotropic medications are drugs that affect a person’s mind, emotions, or behaviour, commonly used to manage distressing symptoms like agitation, anxiety, or hallucinations in dementia patients.
An audit report on psychotropic medication prescribing practices in dementia patients in Jersey’s General Hospital was published following a freedom-of-information request.
The audit aimed to compare prescribing practices in the Island to UK national averages.
It was was commissioned by the Dementia Steering Group, and focused on a random sample of 100 inpatients admitted to the General Hospital between February 2022 and February 2023.
The report found that 77% of psychotropic prescriptions were initiated before hospital admission, mirroring UK averages.
However, the General Hospital had a higher proportion of new prescriptions (23%) than the national audit.
The Island also had a “slightly higher proportion” of hypnotics and anxiolytics, which include sedatives and anti-anxiety medications, being used on a regular basis.
The report also found that the documentation of psychotropic medications in the General Hospital was “inadequate” – with just 31% of new medications having the target symptom recorded.
The audit revealed that only 10% of discharge letters documented changes in psychotropic medications, and communication with community services was identified as a “key challenge”.
The review also described a “gap” in post-discharge care for dementia patients, with
only 13% of patients having a documented follow-up with mental health services after leaving hospital.
The report found that zopiclone was the second most frequently prescribed new medication (22%), despite its documented risks of drowsiness, falls, and cognitive impairment.
Previous reviews had already flagged that zopiclone is “frequently used” in the General Hospital, the report said.
The report called for a training programme for staff focusing on the appropriate use, benefits, and potential side effects of psychotropic medications in dementia care.
It also called for an “improved policy” that outlines “clear guidelines” for prescribing psychotropic medications.
“This policy should include specific protocols for communicating any changes in medication to primary care teams to ensure continuity of care,” the report said.
The audit called for changes to the hospital’s electronic prescribing system to ensure it captures information about the target symptoms for which psychotropic medications are prescribed, and the reasons for discontinuation of these medications.
It also recommended that the documentation of patients’ ethnicity on hospital system should be improved and for another audit to be carried out in one year.
