Assessing the Quality of the Administration of Psychoactive Medication

To assess the methodology of surveys of psychoactive medication treatment, we administered the Psychoactive Medication Quality Assurance Rating Survey (PQRS), a reliable instrument for assessing the quality of the utilization of psychoactive medication via chart review by trained raters, to a simple random sample of 78 residents of an intermediate care facility for persons with mental retardation. By evaluating the clinical information, decision processes, and provisions for monitoring treatment outcome with the use of psychoactive medication, this survey utilizing the PQRS revealed multiple serious deficiencies indicating the need for immediate intervention at the institution consistent with other surveys utilizing different methods. However, a simple screening of residents for excessive dosages and inappropriate combinations of psychoactive agents detected no serious errors. Thus, we demonstrated that the PQRS fulfills its purpose to identify deficits in the utilization of psychoactive medication that are overlooked by mere determination of high doses and atypical combinations. We conclude that the PQRS is a reliable and valid instrument for surveys of the administration of psychoactive medications.