Randomized controlled trial of teaching practice nurses to carry out structured assessments of patients receiving depot antipsychotic injections

Background. A third of patients with schizophrenia are out of contact with secondary services. Many of these patients receive maintenance medication a s depot antipsychotics from practice nurses, most of whom have negligible t raining in mental health. Aim. To examine the impact of a structured assessment on the process of car e and clinical status of schizophrenia patients by practice nurses who rece ived a one-day training course. Method. All identified patients were randomly allocated to structured asses sments and outcome, measured by the number of assessments and the changes i n care recorded in primary care notes. A comprehensive assessment of clinic al and social functioning and level of unmet need in intervention and contr ol patients was carried out after one year by an independent researcher. Results. A high rate of consultation and clinical need in this patient grou p was demonstrated. Practice nurses were more diligent in carrying out asse ssments than general practitioners (GPs), but there was no impact on treatm ent patterns or clinical outcome. Conclusions. Structured assessments by practice nurses are feasible with th is patient group, but training, targeted at both nurses and GPs, is needed if this intervention is to translate into health gain.