The Queensland Mental Health Clinical Collaborative and the Management of Schizophrenia

Abstract

The formation of the Mental Health Clinical Collaborative has brought together clinicians across the State to develop clinical indicators and openly discuss ideas to inform and improve clinical practice. This process has been effective in improving the quality of routinely collected information across the State and in engaging clinicians in using health information to drive clinical practice.

Prevalence and nature of antipsychotic polypharmacy among inpatients with schizophrenia spectrum disorders at an Australian mental health service

“…These differences in rates in the studies could be partially explained by methodological differences, such as focussing exclusively or predominantly on community-dwelling patients, [7][8][9]13 inclusion of patients with non-schizophrenia diagnoses 10 and use of databases, which could underestimate APP rates to gather information. 12 APP rates have been consistently observed to be higher among inpatients and those with diagnosis of schizophrenia, compared to other diagnoses. 5,6 In contrast to other research, a study from New South Wales that included only long stay inpatients found a distinctively higher rate of APP, at 75%.…”

Prevalence of multiple antipsychotic use and associated adverse effects in Australians with mental illness

“…[21][22][23] Some of the studies are now 10 or more years old and the higher rate comes from one study of only 59 patients. 23 There have also been studies of the extent of prescription of dual antipsychotics at discharge.…”

“…23 There have also been studies of the extent of prescription of dual antipsychotics at discharge. A Queensland study conducted across 16 acute mental health inpatient services of patients with schizophrenia reported between 9 and 11% of patients on average were discharged on dual antipsychotics, 21 whereas another Western Australian retrospective audit of 229 inpatients with schizophrenia spectrum disorders reported 43% were prescribed dual antipsychotics at discharge. 22 The proportion of therapy that was dual oral therapy compared with depot injections and oral therapy was not reported.…”

Clinical Practice Improvement Payments: incentives for delivery of quality care

“…16 While it might be argued that limiting the target group to the DRG schizophrenia reduces the number of consumers requiring follow-up, it is worth pointing out that this DRG represents approximately 50% of consumers receiving adult acute mental health inpatient services in Queensland. 17 This, in addition to the application of stricter requirements for the indicator, in particular the exclusion of telephone contact as a follow-up modality, makes the achievement of state-wide improvement over this relatively short time frame worth mentioning.…”