Clozapine deaths: monitoring adverse drug reactions

The reporting and excellent responses to the tragic deaths caused by the side effects of clozapine1 represent ongoing concerns about the quality of patient monitoring, rather than the quality of prescribing. In acute mental healthcare234 and other settings,5 we have shown that the introduction of thorough, structured checks by nurses and care staff can identify problems related to antipsychotics and prompt preventive action. We developed an intervention 67 to facilitate nurse led review of patients with serious mental illness, which pre-empted serious adverse reactions, including chest pain and pancreatitis.2 Monitoring takes 10-20 minutes for each patient, including checks of vital signs, and causes no harm.25 Although it does take the time of frontline staff (nurses and carers), recording constipation, hypersalivation, behaviour change, weight gain, and other problems on a single sheet shared with prescribers and pharmacists can bring real benefits by preventing escalation.Failure to recognise adverse drug reactions is often...

from BMJ Recent Articles http://bit.ly/2UFhsKV
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