Who monitors patients treated with psychotropic drugs in primary care?

Objective. To analyse the degree of monitoring by doctors, nurses, and other health professionals of patients taking psychotropic medication. Design. Retrospective, observational study of patients of both sexes and over 15 years old, who took psychotropic medication and had attended a minimum of ten times the same doctor-nurse primary care unit (PCU). Their monitoring during 2 year-long periods was studied: a first period (the first year after diagnosis) and a second period from October 2001 to October 2002. Setting. Primary care in the Raval Sud District, Barcelona, Spain. Participants. A total of 730 clinical histories were reviewed, of which 200 (27%) met inclusion criteria. Results. The most common diagnosis was anxiety-depression disorder (58%), and 14.5% of patients had no recorded diagnosis. 35.5% were patients taking more than one medicine. The most common drug group was the benzodiazepines (60.4%). Significant differences in the number of controls were found between the 2 periods and between different PCUs. The mean difference between periods was -0.5, with 95% CI at -1.0: clearly the degree of monitoring drops over time. Conclusions. These patients' follow-up was not monitored well, which poses the need to create clear aims and protocols for the doctor-nurse team, to thus assist the treatment of patients with mental health problems.