Senthil Mahalingam
Dr Mahalingam is a Consultant Psychiatrist in Substance Misuse at Derby Drug and Alcohol Recovery Service (DDARS), provided by the Derbyshire Healthcare NHS Foundation Trust, one of the few NHS-led addiction services in the country. He works with patients who take drugs and/or alcohol.
He was shortlisted for the RCPsych Psychiatrist of the year 2018. He secured funding for in-house provision of Tele-ECG, which is now implemented across the Derbyshire Healthcare NHS Foundation Trust. Dr Mahalingam has worked with the Trust’s management in facilitating two ways of sharing of the substance misuse patient record with Primary Care for effective and efficient delivery of care.
Dr Mahalingam facilitated access to Pathology reports and discharge summaries from the inpatient medical and surgical wards to all the Nurses and Prescribers working in DDARS, and he worked with the management team, developing an ongoing ‘high-risk physical health co-morbidity service users’ list within DDARS to manage physical health co-morbidities effectively.
Audit of Benzodiazepine, Zopiclone, Gabapentin and Pregabalin prescribing within Derby Drug and Alcohol Recovery Services (DDARS) and Primary Care for those patients who are on opiate substitute medications
This was a service evaluation audit to determine the number of patients who are prescribed Benzodiazepine, Zopiclone, Gabapentin and Pregabalin within DDARS and Primary Care. The data was collected from shared SystmOne electronic records used by DDARS and Primary Care. 840 patients were on opiate substitute medications but 40 were excluded from the audit as there was no shared access with SystmOne. This was the Fifth audit cycle covering the period 01/07/18 – 30/09/18. All previous audits only included Benzodiazepines.139 patients were prescribed one of the above medications in addition to opiate substitute medications; 26 were prescribed by DDARS and rest by their GP. The benzodiazepine prescribing by DDARS have shown a gradual reduction over the last five audit cycles. In 2018, 13 patients were prescribed benzodiazepine relative to 200+ in 2011, 76 in 2012, 63 in 2013 and 37 in 2014. The audit also analysed Gabapentin, Pregabalin and Zopiclone prescribing practices but their numbers would be more relevant for future audit cycles. 128 patients were on monotherapy (104 prescribed by GP and 24 by DDARS) and 11 patients were on polytherapy (8 prescribed by GP and 3 by DDARS).It is recommended that Prescribers should discuss and document the reasons for prescribing, review it regularly and consider other bio-psycho-social interventions, where appropriate.