Quality improvement through audit: Zuclopenthixol acetate prescribing, monitoring and patient outcomes in a regional health service

OBJECTIVE

Prescribers' expectations of Zuclopethixol Acetate's (ZA) efficacy and tolerability are shaped by clinical experience and organisational culture; however, these expectations may not be consistent with current evidence and best practice.

METHODS

Quality improvement project (QIP) through a process audit of ZA prescribing, monitoring and patient outcomes (adverse events) in order to identify issues requiring intervention to align with service standards and practices.

RESULTS

QIP interventions resulted in a statistically significant shift in psychiatrist oversight, identifying high dose ZA with adverse outcomes and cessation of prescribing/administration within the Emergency Department. Clinically significant changes in patterns of prescribing were observed between pre-post intervention audits.

CONCLUSION

Entrenching an evidence-based QIP approach to clinical practice can effect clinically significant patterns of practice change to improve safe prescribing and drug monitoring.

An open trial of zuclopenthixol in management of acute psychoses : a multicentered study

In an open trial, patients with ICD-10 diagnosis of acute functional psychoses were administered injection Zuclopenthixol acetate (Acuphase) in the initial phase. Patients were rated with CGI, BPRS -24 item and UKU side effect rating scale at baseJine, 24 hours and 72 hours. Of the 120 patients recruited, 119 finished this part of the trial. The most common side effect was sedation, which was preferable as most of the patients were in the acute state. The issues concerning less dosing efficacy and the rapid onset of antipsychotic activity are discussed.Patients who had been administered zuclopenthixol acetate in the acute phase were maintained with injection zuclopenthixol decanoate (depot) starting at 72 hours over the baseline. Patients were assessed at 72 hours, one week, 2 weeks, 3 vseeks, 4 weeks and 8 weeks using the same instruments. The issues concerning the dosage and therapeutic efficacy are discussed.