Hunting on the incoming tide

A full-on morning working from home. Time to deal with many of the outstanding emails. And pleased with one of the new ones. 

A couple of years ago I was appointed the leader of a project to respond to complaints by patients and whanau that doses of antipsychotics were too high. The call was for doses to be reduced and medication stopped. I persuaded the leadership group that an audit was the first step, and after a frustrating delay, a group of pharmacy students combined our need for an audit and their need for a project and conducted the audit under our guidance. The audit confirmed a high level of above recommended dosage prescribing. 

This morning's email was notice that the paper which came from the audit will be published shortly in Psychiatry Research. 

Of importance is that using those data we have written a guideline, supported by a policy document, to help reduce overprescribing by encouraging justification if exceeding recommended maximal doses.

At the end of the morning was a meeting by ZOOM to discuss the treatment and discharge of a young man with bipolar disorder. All of us were struck by the effects of the very large amount of antipsychotic medication he had received in another hospital before coming to us. A  confirmation of the importance of considering carefully what we do.

Later this afternoon, I went to Southend with my camera, where I was able to take photos of spoonbills, known by Maori as Kotuku ngutupapa (there were ten there, the most I have seen at Snells Beach), a number of (the very common) white-faced herons, a Tarapunga (red-billed gull), two Tuturiwhatu (dotterels), one Kuaka, and a solitary Matuku moana which I have blipped.