Adverse drug reactions: managing the risk

Aim  This study aims to assess the need to formalize medication monitoring strategies in electronic records in two crisis resolution home treatment (CRHT) teams in one UK NHS Trust. Background  The management and monitoring of prescribed medications has long been a cause for concern. As a result of the potential adverse drug reactions associated with commonly prescribed medication, clients of mental health teams are vulnerable to iatrogenic risk linked to physical health problems. Method  Electronic records for all clients receiving care in two CHRT teams in one UK mental health Trust in November 2007 were examined for evidence of monitoring for potential adverse drug reactions. Findings were compared with the sample of paper records submitted to a national audit. Results  Electronic records omitted important aspects of medication monitoring, for example: 14 out of 57 clients had blood pressure recorded; 15 out of 57 had heart rate recorded; 13 out of 57 had weight recorded. However, the teams’ paper records were significantly better than both the electronic records and a national audit sample at recording blood pressure and obesity. We found few differences between our two teams. Conclusions  The format of our electronic records requires modification to ensure that systems are in place to document adverse drug reactions and the physical health of those with mental illness. Implications for nursing management  The transition to electronic records needs to be carefully managed to ensure that information on adverse drug reactions is included. The West Wales Adverse Drug Reaction profile, version II, is one strategy to achieve this in mental health.