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Use of Psychoactive Medications in Hong Kong Institutions for Adults with Severe to Profound Learning Disabilities: A Retrospective Study (1988–2003) and Economic Analysis
Author(s) -
Lim Winston Woon Chu
Publication year - 2007
Publication title -
journal of applied research in intellectual disabilities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 63
eISSN - 1468-3148
pISSN - 1360-2322
DOI - 10.1111/j.1468-3148.2006.00357.x
Subject(s) - medical prescription , polypharmacy , medicine , antipsychotic , audit , psychomotor learning , drug , psychiatry , pediatrics , emergency medicine , pharmacology , schizophrenia (object oriented programming) , cognition , management , economics
Background Little information is available about prescribing patterns for patients with severe learning disabilities in Asian institutions. Materials and methods Prescription audits were performed at Siu Lam Hospital (SLH) and Tuen Mun Hospital (TMH), Hong Kong, between 1988 and 2003. Results About 65% of patients were receiving psychoactive medication. Male patients at TMH (but not at SLH) were more likely to receive psychoactive drugs than female (74% versus 58%). Polypharmacy occurred in around 30%. The proportions receiving anticonvulsants, lithium or benzodiazepines increased, while those receiving anticholinergics decreased. The most common indication for antipsychotic use was ‘acute psychomotor agitation’ but 14–22% had no recorded indication. About 20–27% of prescriptions fell outside recommended daily dosages. Drug spending as a proportion of the total fell from 9% to 5%. Daily drug costs per patient were about HK$4. Conclusions Changes in prescribing have occurred since 1988. Drug audits can improve prescribing for this vulnerable population.