Electrocardiographic Monitoring of Psychiatric In-patients Taking Antipsychotic Medications

To assess the adherence to guidelines for electrocardiographic (ECG) monitoring in Hong Kong psychiatric in-patients who have been prescribed antipsychotic medications.

In-patients who had been prescribed antipsychotic drugs on hospital admission during the baseline audit period of 15 April 2015 to 16 July 2015 and the re-audit period of 28 January 2016 to 30 April 2016 were included. Quality improvement interventions were delivered after the baseline audit. ECG monitoring adherence was categorised as full adherence (ECG before taking antipsychotics), partial adherence (ECG after taking antipsychotics), or non-adherence (no ECG during hospital stay). Overall compliance was defined as full adherence plus partial adherence.

The baseline audit and re-audit included 378 and 422 patients, respectively. Overall compliance with ECG monitoring increased significantly from the baseline audit to re-audit (40.2% vs. 69.9%; p < 0.001). Case-doctors having the grade of resident was associated with stronger adherence to ECG monitoring in both audits.

Adherence to ECG monitoring guidelines for in-patients who are prescribed antipsychotic drugs is low in Hong Kong, and junior doctors (residents) demonstrate stronger adherence than moresenior doctors.