Electroconvulsive therapy in Oman: a national audit of demographics and standards

Background We aim to address the dearth of knowledge regarding general electroconvulsive therapy practice in Oman, by examining and investigating the electroconvulsive therapy practices at all hospitals providing electroconvulsive therapy across the country, and to compare our local practice against the National Institute for Health and Care Excellence guidelines on the appropriate use of electroconvulsive therapy to inform the development of guidelines locally. Sultan Qaboos University Hospital and Al Masarra Hospital were included in a nationwide audit of all hospitals in Oman that administer electroconvulsive therapy. The demographics, diagnostic and electroconvulsive therapy indications, treatment characteristics, and side-effect profiles of all patients who had electroconvulsive therapy between January 2019 and December 2020 were collected from the hospital's electronic data. A descriptive analysis of the results was performed. Results The total number of patients was 197 (92 males and 105 females). The most common diagnosis was schizophrenia 32.5%, followed by major depressive disorder 31.5%. The most common immediate side effect was headache 10.2%, followed by dizziness 7.1%, and amnesia 4.1%. Only 57.4% of patients who received electroconvulsive therapy met the NICE guidelines for appropriate electroconvulsive therapy use. Clinical status was assessed after each electroconvulsive therapy session for 66% of patients, and cognitive function monitoring was achieved for only 7.6% of patients. Conclusions The current audit has indicated that the assessment of the clinical status and cognitive functions of electroconvulsive therapy patients is inadequate. Because there is a significant rate of cognitive dysfunction following electroconvulsive therapy delivery, cognitive assessment before, during, and after therapy should be more rigorously implemented and documented.