Implementation of Early Psychosis Intervention Program ... - EENet

54Table 16: Procedures and protocol for anti-psychotic medications monitoringSurvey QuestionResponse (% yes)Q85: Program has written procedures for anti-psychotic medications monitoring 45Q86: Items in monitoring protocol:- Side effects 85- Metabolic disruption/wt gain 79- Blood work 69- Informed consent 65Main challenges to administering anti-psychotic medications noted by programs:o Cost of drugs for clients was noted by 64% of siteso Some sites mentioned: access to medical expertise (15%), medical support for clients under16 (10%); staff skills (8%); providing medical monitoring (15%).o Also noted by some sites were: client compliance and choices, lack of knowledge of EPIpractices among some medical professionals, medications not being effective, and constraintsdue to staffing and psychiatry resources.Strategies suggested by programs for administering anti-psychotic medications:o Developing relationships with pharmaceutical company reps to obtain free drug samples anda compassionate supply.o Medications-related education and support for the client and family.o Nursing staff on EPI team; also offering capacity to do injections in the home.What would help programs for administering low dose anti-psychotic medications:o Improved client access to drug benefits through existing programs such as ODSP andTrillium, & access to compassionate supply of medication if needed.o Education for health care professionals working with EPI clients to be more knowledgeableabout best practices in EPI.o Prioritizing ongoing and consistent monitoring of clients for compliance and side effects.o Additional staffing and physician resources, and increased capacity to be able to offer aninjectable service.4. Physical health monitoringStandard 3 outlines expectations related to ongoing medical assessment and general physicalhealth monitoring. This includes closely monitoring clients taking anti-psychotic medications forside effects, and addressing physical health issues in a timely fashion either directly or throughreferrals to other services.Summary of Results:o Overall moderate implementation of Standard related to physical health monitoring with 75%of programs reporting implementing this element ‘most of the time’; rates were somewhatlower in small program sites (57%).o Access to primary care (PC) physicians was identified as a challenge. 57% of program sitesoverall reported that most of their clients are followed by a primary care physician, and the