Mental Health

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Australian and New Zealand Journal of Mental Health Nursing (2000) 9, 166–176

F EATURE A RTICLE

The use of the Liverpool University neuroleptic side-effect rating scale (LUNSERS) in clinical practice Paul Morrison,1 Deanne Gaskill,2 Tom Meehan,2 Paul Lunney,2 Gayle Lawrence2 and Paul Collings2 1

School of Nursing, University of Canberra, ACT 2601 and 2Centre for Nursing Research, Queensland University of Technology, Kelvin Grove Campus, Brisbane, Qld 4509, Australia

ABSTRACT: Forty-four mental health clients completed the Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS)—a self-rating scale to assess the prevalence and intensity of neuroleptic side-effects. In the month prior to the study, 50% of the clients surveyed had experienced more than half of the side-effects outlined on the 41-item scale. A prevalence profile allowed us to rank the frequency of individual side-effects across the sample. Some side-effects such as ‘difficulty concentrating’, ‘difficulty remembering’, ‘tiredness’ and ‘restlessness’ were experienced by most of the clients in the study while ‘unusual skin marks’, ‘difficulty passing water’, ‘rashes’ were experienced by a few. A prevalence profile may be a useful guide in developing strategies for managing side-effects more effectively in small groups of clients. In addition, the use of the LUNSERS in clinical practice would enable case managers to establish baseline measures for individual clients and evaluate changes in medication and other non-medical strategies for reducing unwanted side-effects. The identification and assessment of antipsychotic side-effects is an important area for client and professional carer education. KEY WORDS: antipsychotic medication, case manager, LUNSERS, side-effects.

INTRODUCTION
The aim of this paper is to describe how the Liverpool University Neuroleptic Side-Effect

Correspondence: Paul Morrison, School of Nursing, University of Canberra, ACT 2601, Australia. Email: paul.morrison@canberra.edu.au Paul Morrison, BA(Hons), PhD, RMN, RGN, PGCE, AFBPsS, CPsychol, MAPS. Deanne Gaskill, RN, BAppSc, GradDipHSc, MAppSc. Tom Meehan, RN, BHlthSc, MPH, MSocSc, GDip(Data Analysis), FANZCMHN. Paul Lunney, BDSc(Hons), GradDipAppFin, MBA. Gayle Lawrence, RPN, RN, BHSc(Nurs). Paul Collings, BA(Hons), PhD. Accepted May 2000.

Rating Scale (LUNSERS) was used as part of a recently completed research study designed to enhance case managers’ skills in the assessment of antipsychotic medication side-effects. The emphasis here is on the potential use of the scale in clinical practice for assessing and monitoring clients who are prescribed antipsychotic medication.

BACKGROUND
Neuroleptic medications continue to dominate the list of options available for the treatment of schizophrenia and other psychotic disorders. A number of recent studies have demonstrated the

ASSESSMENT OF ANTIPSYCHOTIC MEDICATION SIDE-EFFECTS

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role of antipsychotic medications in producing better outcomes for people with psychotic illness (Chen, 1991; Hirsch et al., 1996). While Chen (1991) noted the importance of psychosocial and vocational rehabilitation, case management and supportive therapy in the care of seriously mentally ill people, he highlighted the importance of pharmacotherapy as the ‘mainstay’ of treatment. In a recent study into schizophrenic relapse, Hirsch et al. (1996, p. 49) found that ‘patients who continued on regular medication had 80% less risk of relapse than those who had been withdrawn from medication either by choice or under double-blind controlled [research] conditions’. Compliance with medication following discharge from hospital in patients suffering from schizophrenia or bipolar affective disorder was also found to be ‘correlated significantly with longer stays in the community’ (Fernando, Velamoor, Cooper & Cernovsky, 1990, p. 72). However, it is now clear that antipsychotic medications can also produce a range of adverse effects which...
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