Exploring the clinical factors affecting lithium dose and plasma level and the effect of brand.

Background: Optimal use of lithium involves adjustment of the dose, to keep the plasma level within the narrow, recommended range. Brand-specific prescribing has long been considered critical to achieving this aim, but this is a convention based on very limited data.

Objectives: To explore the effect of selected demographic and clinical factors on the relationship between lithium dose and plasma level and determine whether there is an independent effect of lithium brand.

Understanding the medication regimens associated with anticholinergic burden in older people's mental health services in the UK.

Background: Medications with anticholinergic properties are associated with a range of adverse effects that tend to be worse in older people.

Aims: To investigate medication regimens with high anticholinergic burden, prescribed for older adults under the care of mental health services.

Method: Clinical audit of prescribing practice, using a standardised data collection tool.

Quality of melatonin use in children and adolescents: findings from a UK clinical audit.

Background: Melatonin is commonly used to treat sleep disturbance in children and adolescents, although uncertainties about its optimal use remain.

Objective: To determine to what extent prescribing of melatonin complies with evidence-based clinical practice standards.

Methods: As part of a quality improvement programme, the Prescribing Observatory for Mental Health conducted a retrospective clinical audit in UK services for children and adolescents.

Management of medically assisted withdrawal from alcohol in acute adult mental health and specialist addictions in-patient services: UK clinical audit findings.

Background: Medically assisted alcohol withdrawal (MAAW) is increasingly undertaken on acute adult psychiatric wards.

Aims: Comparison of the quality of MAAW between acute adult wards and specialist addictions units in mental health services.

Method: Clinical audit conducted by the Prescribing Observatory for Mental Health (POMH).

Who is prescribed valproate and how carefully is this treatment reviewed in UK mental health services? Data from a clinical audit.

Background: The licensed indications for valproate are narrow, yet this medication is commonly prescribed in mental health services.

Objectives: To explore the target symptoms/behaviours for which valproate is prescribed and how well the efficacy and tolerability of this treatment are monitored in routine clinical practice.

Design: An audit-based quality improvement (QI) programme in UK mental health services.

Prescribing antipsychotic medication for adults with intellectual disability: shared responsibilities between mental health services and primary care.

Aims And Method: We conducted a secondary analysis of data from a Prescribing Observatory for Mental Health audit to assess the quality of requests from intellectual disability services to primary care for repeat prescriptions of antipsychotic medication.

Results: Forty-six National Health Service Trusts submitted treatment data on 977 adults with intellectual disability, receiving antipsychotic medication for more than a year, for whom prescribing responsibility had been transferred to primary care. Therapeutic effects had been monitored in the past 6 months in 80% of cases with a documented communication indicating which service was responsible for this and 72% of those with no such communication.