• antipsychotics;
  • cost;
  • Hong Kong;
  • learning disability;
  • prescribing;
  • psychoactive drugs

Background  Little information is available about prescribing patterns for patients with severe learning disabilities in Asian institutions.

Materials and methods  Prescription audits were performed at Siu Lam Hospital (SLH) and Tuen Mun Hospital (TMH), Hong Kong, between 1988 and 2003.

Results  About 65% of patients were receiving psychoactive medication. Male patients at TMH (but not at SLH) were more likely to receive psychoactive drugs than female (74% versus 58%). Polypharmacy occurred in around 30%. The proportions receiving anticonvulsants, lithium or benzodiazepines increased, while those receiving anticholinergics decreased. The most common indication for antipsychotic use was ‘acute psychomotor agitation’ but 14–22% had no recorded indication. About 20–27% of prescriptions fell outside recommended daily dosages. Drug spending as a proportion of the total fell from 9% to 5%. Daily drug costs per patient were about HK$4.

Conclusions  Changes in prescribing have occurred since 1988. Drug audits can improve prescribing for this vulnerable population.