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Medicines reconciliation at the community mental health team-general practice interface: quality improvement study.

Chris F JohnsonKaren LiddellClaudio GuerriPaul FindlayAlex Thom
Published in: BJPsych bulletin (2019)
Aims and methodTo increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)-general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs. RESULTS: One CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: 'fatal' (0%), 'serious' (17%) and 'negligible/minor harm' (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.Clinical implicationsImprovements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.Declaration of interestNone.
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