Monitoring physical health and adverse effects in children and adolescents prescribed antipsychotics

Background: The adverse effects and long-term health risks associated with antipsychotic use means that monitoring children and adolescents prescribed these medications is important. Aim: To implement an evidence-based chart and guideline to monitor physical health and adverse effects in children and adolescents prescribed antipsychotics in a range of practice settings; and to identify the barriers and benefits of implementation. Method: Using an action research approach a pilot trial was undertaken to implement a chart and guideline in a range of practice settings. Patient and health professional resource kits and an information compact disc were produced to facilitate implementation. Barriers identified during implementation were doctor/health professional, patient-related and environmental. Carer and doctor satisfaction questionnaires were administered to assess the implementation process and evaluate the quality and usefulness of the monitoring chart and guideline. Results: 10 doctors were recruited to participate in the implementation trial and 21 patients prescribed antipsychotics were enrolled. Monitoring data collected retrospectively from patients' case notes, such as weight/height measurements and haematological monitoring were congruent with the guideline in 41% and 29% of patients respectively. Carer and doctor satisfaction questionnaires indicated that the monitoring package was well received and raised awareness of potential adverse effects and the importance of monitoring. Conclusion: The monitoring package can bridge the evidence to practice gap regarding monitoring physical health and adverse effects in children and adolescents prescribed antipsychotics.