{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:07:05Z","timestamp":1774328825381,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013483","name":"Betsi Cadwaladr University Health Board","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Criminal Behav Ment Health"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The widespread use of drugs in prisons leads to avoidable deaths, poorer health and a poor living environment. The contribution of psychoactive prescription drugs to this problem has received little attention in prison policy or at individual prescriber level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the extent of unsafe and inappropriate prescribing of psychoactive medications in one UK prison using a newly developed medicines optimisation framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A medicines optimisation framework was developed based on principles of good prescribing. It was initiated on the opening of a new prison\u2014HMP Berwyn\u2014in February 2017. During the study period, all prisoners at HMP Berwyn were transferred from other prisons. The safety and appropriateness of psychoactive medications were evaluated de novo on reception at HMP Berwyn and during follow up, using the medicines optimisation framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 1941 sentenced men arrived at HMP Berwyn between February 2017 and November 2018. Nearly one\u2010third (634, 33%) were on a prescribed psychoactive medication. Seventy\u2010five percent of these (474\/634) required a prescription change due to appropriateness or safety concerns. Nearly half (295, 46.5%) received changes at reception despite having already undergone medicines reconciliation at their previous prison. Forty\u2010three percent (275\/634) received changes at follow up, most commonly those who had no prior risks identified at reception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inappropriate and unsafe prescribing of psychoactive medications is occurring in prisons despite mandatory medication reviews. Ongoing monitoring is required to reduce the risk from these medications. A medicines optimisation framework such as this could be adopted across other prisons, worldwide, to help contribute to risk reduction from drug use in prisons. Appropriately modified, a similar framework might help reduce inappropriate and harmful prescribing in hospitals and in the community.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cbm.2187","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T15:06:14Z","timestamp":1607699174000},"page":"131-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of a framework for safe and appropriate prescribing of psychoactive medications in a UK prison"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1332-7558","authenticated-orcid":false,"given":"Emily","family":"Bebbington","sequence":"first","affiliation":[{"name":"Centre for Mental Health and Society Bangor University  Wrexham Wales, UK"},{"name":"Department of Emergency Medicine Ysbyty Gwynedd  Bangor Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-6411","authenticated-orcid":false,"given":"Justin","family":"Lawson","sequence":"additional","affiliation":[{"name":"HMP Berwyn  Wrexham Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-3013","authenticated-orcid":false,"given":"Sadia","family":"Nafees","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Society Bangor University  Wrexham Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7240-7107","authenticated-orcid":false,"given":"Catherine","family":"Robinson","sequence":"additional","affiliation":[{"name":"Social Care and Society School of Health Sciences, Manchester University  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7914-3981","authenticated-orcid":false,"given":"Rob","family":"Poole","sequence":"additional","affiliation":[{"name":"Centre for Mental Health and Society Bangor University  Wrexham Wales, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp13X670615"},{"key":"e_1_2_10_3_1","volume-title":"Safer prescribing in prisons","author":"Bicknell M.","year":"2019"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijpp.12089"},{"key":"e_1_2_10_5_1","volume-title":"Good practice in prescribing and managing medicines and devices","author":"General Medical Council","year":"2013"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-1055-7"},{"key":"e_1_2_10_7_1","volume-title":"HMP Berwyn","author":"HM 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population bulletin: Monthly March 2019","author":"Ministry of Justice","year":"2019"},{"key":"e_1_2_10_15_1","volume-title":"The worrying increase of drug\u2010related deaths in custody","author":"Moody E.","year":"2019"},{"key":"e_1_2_10_16_1","volume-title":"Medicines optimisation: The safe and effective use of medicines to enable the best possible outcomes","author":"National Institute for Health and Care Excellence","year":"2015"},{"key":"e_1_2_10_17_1","volume-title":"Physical health of people in prison","author":"National Institute for Health and Care Excellence","year":"2016"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004411"},{"key":"e_1_2_10_19_1","article-title":"The opioid crisis and British prisons","author":"Poole R.","year":"2019","journal-title":"Criminal Behaviour and Mental Health"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2016.10.003"},{"key":"e_1_2_10_21_1","volume-title":"Professional 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