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Use of a prescribing protocol in routine clinical practice

experience following the introduction of donepezil

University of Leicester, Division of Psychiatry for the Elderly, the Bennion Centre, Glenfield General Hospital, Groby Road, Leicester LE3 9DZ

¹ The protocol currently followed in Leicestershire is a modified version of the 1997 protocol but the principal components are essentially the same.

AIMS AND METHOD

Following the introduction of donepezil into clinical practice a protocol for prescribing it was developed in Leicestershire. A prospective clinical audit was undertaken to monitor compliance with the protocol, which also provided an opportunity to evaluate the outcome of therapy in routine clinical practice.

RESULTS

Overall there was close adherence to the protocol by the clinicians and clinical factors, as well as organisational and resource-related factors, were important in determining who received treatment. The principal outcome measures (Mini-Mental State Examination, Barthel ADL Index and Clinical Dementia Rating Scale) did not demonstrate any significant treatment effect.

CLINICAL IMPLICATIONS

This study demonstrates the feasibility and acceptability of using a protocol-based approach to manage the introduction of new drug treatments in psychiatry.