Focus on patient safety - "Neuroleptic medication. Vigilance is best practice"

Context

In 2000, a study conducted by the French National Health Insurance revealed that a quarter of French people covered by the general health insurance scheme took psychotropic medications. The most widely used psychotropic drugs include anxiolytics (17.4%), followed by antidepressants (9.7%), hypnotics (8.8%) and neuroleptics (2.7%).

In 2014, the Baromètre santé health survey, conducted by the French National Prevention and Health Education Institute, confirmed that France continued to be one of the biggest consumers of psychotropic medications in Europe. Neuroleptics were shown to be the least used psychotropic drugs. But since they are essential to patients’ quality of life, regular monitoring is necessary to prevent any serious adverse events related to their therapeutic effects.

The HAS national care-related serious adverse event reporting database highlights 60 serious events related to neuroleptic misuse, a third of which are related to the absence of regular assessment of neuroleptic treatment.

Objectives

By sharing feedback from professionals faced with these care-related serious adverse events, this focus aims to :

• alert healthcare professionals and care teams as to the occurrence of care-related serious adverse events that could have been avoided by the follow-up of patients on neuroleptic medication and regular assessment of their treatment,
• raise awareness among healthcare professionals as to the prevention of these care-related serious adverse events,
• improve information and training for healthcare personnel on best practices for the monitoring of patients on neuroleptic medications and the recognition of warning signs.

So it doesn’t happen again

The analysis of care-related serious adverse events reveals that the main root causes of these events are inadequate patient monitoring, the absence of regular assessment of their treatment, and a lack of awareness of the serious adverse effects and risks incurred by patients treated with a neuroleptic drug, which should lead them to rapidly consult a physician. 

The management of these patients is hinged around four preventive actions :

• information,
• screening,
• monitoring,
• awareness-raising.