Monitoring of extrapyramidal side effects in patients on antipsychotic treatment: a completed audit cycle

Documentation of antipsychotic-related adverse drug reactions: An educational intervention

Background

Antipsychotic agents are associated with harmful adverse reactions which impact negatively on patient adherence and clinical management. Accurate and complete documentation of signs and symptoms in the clinical notes is an important means of communication between healthcare providers, and an essential component in the management of antipsychotic-induced adverse drug reactions.

Aim

To determine the impact of an educational intervention on the incidence and extent of antipsychotic-induced adverse drug reaction documentation in patient medical records.

Setting

The research was conducted in an acute care, public sector psychiatric facility in the Eastern Cape province of South Africa.

Methods

A quasi-experimental, before and after method was used, which focused on an educational intervention. The study design consisted of three phases: pre-intervention, intervention and post-intervention. A clinical audit was conducted, reviewing 102 patient medical records in the pre-intervention phase and a further 102 patient medical records in the post-intervention phase, in order to determine the impact of the intervention on the frequency and extent of documentation of suspected antipsychotic-induced adverse drug reactions.

Results

Following the educational intervention, documentation of adverse drug reactions to antipsychotic drugs increased from 66 instances in the pre-intervention phase to 82 instances in the post-intervention phase. A statistically significant increase (Pearson's Chi-square p < 0.05) was observed in the number of patient medical records that identified suspected adverse drug reactions.

Conclusion

The educational intervention was found to increase the incidence of documentation of adverse drug reactions, and increased awareness of the potential adverse drug reactions associated with antipsychotic drugs following the intervention.