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Tijdschrift voor Psychiatrie 41 (1999) 11, 5 - 14

New research

Het voorschrijfbeleid in Algemeen Psychiatrische Ziekenhuizen in Nederland: de mate van inbedding in een kwaliteitszorgsysteem

D.R. Witte, G.H.M.M. ten Horn, A.M. Koster, R.M.W Smeets

The Inspectorate for Healthcare investigated, on request of the Minister of Health, Welfare and Sport, to which extend general psychiatric hospitals have a quality-policy in relation to the pharmaceutical supply and prescription and the use of guidelines and protocols. A questionnaire was mailed to all 43 general psychiatric hospitals in the Netherlands with questions about the policy of the hospital in relation to prescription and the use of protocols. The respons was 100%. Policy of these hospitals in relation to prescription meets the relevant standards, except for the full description of the policy in policydocuments (about half of the hospitals has realised this). Almost all hospital-boards said to work with protocols: about 180 different protocols about 53 different subjects were counted. All in all policy in relation to prescription in general psychiatric hospitals is little based on guidelines. The extent to which the hospitals have implemented their policy and to which the protocols are imbedded in the hospital quality system varies. A substantial number of hospitals has a pharmaceutical-formularium. Most of these meet the criteria for order, content and implementation. Less so is the case for the procedure to prescribe outside the formularium. Most hospitals do have a pharmaceutical-committee with (for about 80%) written tasks. These committees advice psychiatrists and the board of the hospital about a broad range of subjects. Prescription-behavior is seldom (19%) discussed with the client-board. In conclusion: especially the implementation of guidelines and protocols for prescription in the daily practice of psychiatric hospitals needs further attention.