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A comparison of the implementation of assertive community treatment in Melbourne and London

254 health clinics in Melbourne (n = 83), their carers (n = 60) and their clinicians (n = 66) completed a questionnaire on the effectiveness, acceptability and side-effects of current, previous and early antipsychotic medicine. Medicine use was determined from clinical records. Results: Patients were predominantly single middleaged women. A signifi cant shift over time toward atypical medicine use had occurred: 66% were currently taking atypicals; compared with early medicines, current medicines were three times more likely to be atypical (odds ratio: 2.95, 95% confi dence interval: 1.48–5.88). Major discrepancies were noted in reports of medicines used between patients, carers, clinicians and clinical notes. Doctors made 61% of all recommendations for changes in previous medicines. There were few signifi cant differences in perceived effectiveness, satisfaction and side-effects when comparing types of medicine. Health-related quality of life was associated with reported side-effects, but not with current medicine type. Conclusions: There is a mutual lack of information and understanding about antipsychotic medicines between patients, their carers and clinicians. Greater reinforcement of provisions and incentives for collaborative treatment planning may be benefi cial. Further studies of the uptake of atypical antipsychotics and their benefi ts should be conducted in real-world settings.