An quality assurance program evaluating prescription for tardive dyskinesia in French psychiatric hospitals: integration of Cochrane systematic reviews as an evidence-based reference

Article type
Authors
Amsallem E, Lachaux B, Haugh M, Boissel J
Abstract
Introduction: Neuroleptic-induced tardive dyskinesia is a disabling condition affecting about 20 to 30% of patients taking neuroleptics. In France, the importance of this condition is probably underestimated, and thus we decided to undertake a study of its prevalence, and psychiatrists' prescribing behavour, in a quality assurance program. The Cochrane systematic reviews dealing with treatment of tardive dyskinesia will be integrated to provide an evidence-based reference. The design of this study and the preliminary results will be presented

Objective: To estimate the prevalence of neuroleptic-induced tardive dyskinesia in a population of French psychiatric patients, and to assess the prescription behaviour, using an evidence-based reference integrating Cochrane systematic reviews. The results of this assessment will then be presented to the psychiatrists during an individual interview, and their prescription behaviour will then be reassessed to obtain an estimate of the change induced by the program.

Methods: The study will comprise three phases: 1) a cross-sectional baseline survey; 2) a feed-back and continuing education phase; 3) a cross-sectional evaluation study. During the first phase (May to August 1998) the following information on all patients seen in 23 psychiatric in and out-patient clinics will be collected: diagnosis, comorbidity, medical history, and current treatments. The percentage of concordant prescriptions for the treatment of tardive dyskinesia will be estimated using the evidence-based reference (Cochrane systematic reviews). These results will be available. The second phase will involve a workshop on the methods and interpretation of systematic reviews (facilitated by members of the Centre Cochrane Français) and individual interviews with the psychiatrists during which their prescription assessment will be discussed. This will be followed by, six months later, the third and final evaluation phase during which the impact of the second phase will be assessed.