A single or more than two Antipsychotics above the recommended dose is known as High Dose prescription. Regular review of these patients is necessary due to the potential side effects.

Reviewing of the HDAT prescription and monitoring process between June and July 2010.

Standard - TEWV NHS Trust guidelines suggest that patients on High Dose Antipsychotics should have

1. 1) Documentation of Medical history and Physical examination at the Well Being Clinic

2. 2) Medication Alert on PARIS (Trust intranet)

3. 3) Documentation on Visual display Board

4. 4) Regular Blood tests and ECG

Referring Case notes, PARIS entries and Visual Display board.

Of the 8 patients at Well Being Clinic, Male −4, Female −4.

Details of medical history & physical examination were recorded for all patients.

Medication alerts were documented on PARIS.

Visual display board was up to date with dates for bloods & ECG. Bloods tests - FBC,U&E, LFT, Lipids, Blood glucose & Prolactin. The tests were done at baseline, repeated on 1,2,3,6,9,12 months & at dose increment. All the blood tests & ECGs were up to date. 2 male patients were discharged following dose review. Once the patients were discharged, the alert on PARIS was removed.

1 male patient was referred to GP for physical examination as the patient was quite obese. Prolactin levels of 2 patients were high. They were followed up with further blood investigations.

• • Side effect monitoring scales like “LUNSERS” to be used

• • Arrange educational meetings to the Support workers.