Enhancing case managers' skills in the assessment and management of antipsychotic medication side-effects

• Published in: Australian and New Zealand journal of psychiatry Vol. 34; no. 5; p. 814
• Main Authors: Morrison, P, Meehan, T, Gaskill, D, Lunney, P, Collings, P
• Format: Journal Article
• Language: English
• Published: England 01.10.2000
• Subjects: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Aged; Antipsychotic Agents - adverse effects; Australian Capital Territory - epidemiology; Case Management; Dyskinesia, Drug-Induced - epidemiology; Dyskinesia, Drug-Induced - prevention & control; Female; Follow-Up Studies; Humans; Male; Mental Disorders - drug therapy; Mental Disorders - psychology; Middle Aged; Patient Compliance - psychology; Patient Compliance - statistics & numerical data; Patient Education as Topic - methods; Pharmacology - education; Surveys and Questionnaires; Treatment Outcome; Australian Capital Territory
• ISSN: 0004-8674
• DOI: 10.1080/j.1440-1614.2000.00821.x

Our goal was to reduce the prevalence of antipsychotic medication side-effects by providing a short-term training program on the assessment and management of side-effects to case managers. Forty-four patients in receipt of community-based mental health services were allocated to comparison (n = 20) and intervention (n = 24) groups based on the health service district in which they resided. While case managers working with the intervention group attended a short-term training program to improve their assessment and management of neuroleptic side-effects, case managers providing services to the comparison group received no additional training. Side-effects were assessed pre- and postintervention using the Liverpool University Neuroleptic Side-effect Rating Scale (LUNSERS). A reduction in the overall prevalence of side-effects in both groups was observed, however, only those patients in the intervention group reported a statistically significant reduction in mean side-effect scores between the pre- and postmeasures (Wilcoxon Matched Pairs Signed-ranks Test, z = -2.8411, two-tailed, p < 0.01). In addition, qualitative data collected during the second survey revealed that patients in the intervention group had acquired some positive management strategies for dealing with unwanted side-effects. The strategies were elicited from eight different patients distributed across six of the 12 case managers who took part in the training program. Training cases managers in the assessment and management of side-effects may help to reduce their impact on the lives of people prescribed neuroleptic medication.