scholarly journals Improving physical health monitoring for out-patients on antipsychotic medication

2010 ◽  
Vol 34 (3) ◽  
pp. 91-94 ◽  
Author(s):  
Carlos Gonzalez ◽  
Niyaz Ahammed ◽  
Robert Fisher
Keyword(s):  
Mental Illness ◽  
Inner City ◽  
Physical Health ◽  
Health Monitoring ◽  
Health Assessment ◽  
Clinical Implications ◽  
Blood Testing ◽  
Routine Blood ◽  
Physical Morbidity

Aims and methodMental illness is associated with increased physical morbidity. We aimed to assess and improve the routine blood testing of prescribed antipsychotics in out-patients from a busy London inner city area. Audit findings were presented locally to prescribers, together with educational suggestions to improve physical health assessment.ResultsInitially, the numbers monitored were low in the overall number of 126 patients included in the first audit. Following the intervention, this improved significantly in the second audit (of 106 patients).Clinical implicationsA simple one-page monitoring prompt and an educational intervention could significantly increase the adherence to routine blood-testing guidelines. Better physical screening may help reduce physical morbidity and mortality, and improve the quality of life of individuals with mental illness.

Monitoring the physical health of individuals with serious mental illness

2008 ◽  
Vol 25 (3) ◽  
pp. 108-115
Author(s):  
Majella Cahill ◽  
Anne Jackson
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Monitoring ◽  
Service Providers ◽  
Psychiatric Service ◽  
Service Users ◽  
Effective Models

AbstractDeveloping effective models of identifying and managing physical ill health amongst mental health service users has become an increasing concern for psychiatric service providers. This article sets out the general professional and Irish statutory obligations to provide physical health monitoring services for individuals with serious mental illness. Review and summary statements are provided in relation to the currently available guidelines on physical health monitoring.

scholarly journals Physical monitoring and advice: absence of evidence is not evidence of absence

2015 ◽  
Vol 21 (2) ◽  
pp. 75-77
Author(s):  
Katharine Smith
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Health Monitoring ◽  
Poor Quality ◽  
Future Research ◽  
Cost Benefits ◽  
Cochrane Reviews ◽  
Different Types ◽  
Physical Health Problems ◽  
General Physical

SummaryIndividuals with severe mental illness have increased rates of physical health problems and reduced life expectancy. As a vulnerable population, they have been identified as needing increased physical health monitoring and treatment. The first of two Cochrane reviews considered here assessed the evidence for the benefit of monitoring but found no studies that could be included. The second reviewed the evidence for provision of general physical healthcare advice. Although the results were suggestive of benefit, the evidence, where available, was of poor quality. These reviews highlight an important area for future research to evaluate the relative health and cost benefits of different types of intervention.

scholarly journals Improving life expectancy in people with serious mental illness: Should we place more emphasis on primary prevention?

2017 ◽  
Vol 211 (4) ◽  
pp. 194-197 ◽  
Author(s):  
Athif Ilyas ◽  
Edward Chesney ◽  
Rashmi Patel
Keyword(s):  
Cardiovascular Disease ◽  
Mental Illness ◽  
Primary Prevention ◽  
Life Expectancy ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Monitoring ◽  
Prevention Strategies ◽  
Everyday Clinical Practice ◽  
Exercise Interventions

SummaryPeople with serious mental illness have a reduced life expectancy that is partly attributable to increased cardiovascular disease. One approach to address this is regular physical health monitoring. However, physical health monitoring is poorly implemented in everyday clinical practice and there is little evidence to suggest that it improves physical health. We argue that greater emphasis should be placed on primary prevention strategies such as assertive smoking cessation, dietary and exercise interventions and more judicious psychotropic prescribing.

scholarly journals Antipsychotic monitoring in dementia: quality of completion of antipsychotic monitoring forms in an older adult mental health service

2021 ◽  
pp. 1-7
Author(s):  
Helen Anderson ◽  
Anna Kolliakou ◽  
Daniel Harwood ◽  
Nicola Funnell ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Monitoring ◽  
Psychological Symptoms ◽  
Antipsychotic Treatment ◽  
Pharmacological Interventions ◽  
Health Records ◽  
People With Dementia ◽  
Adult Mental Health Service

Aims and method To support safe prescribing of antipsychotics in dementia, antipsychotic monitoring forms were embedded into our electronic health records. We present a review of the data collected on these forms to assess prescribing and identify areas for improvement in our practice and processes. Data were extracted from the structured fields of antipsychotic initiation and review forms completed between 1 January 2018 and 31 January 2020. Results We identified gaps in practice where improvements could be made, mainly with regard to physical health monitoring (and particularly electrocardiograms, performed in only 50% of patients) and the low (less than 50%) recorded use of non-pharmacological interventions for behavioural and psychological symptoms of dementia. In addition, antipsychotic treatment was continued despite lack of benefit in almost 10% of reviews. Clinical implications We advocate for recommendations on physical health monitoring of people with dementia taking antipsychotics to be added to the National Institute for Health and Care Excellence guidance on dementia and the Prescribing Observatory for Mental Health (POMH-UK) national audit.

scholarly journals Mechanisms in endocrinology: Antipsychotic medication and type 2 diabetes and impaired glucose regulation

2018 ◽  
Vol 178 (6) ◽  
pp. R245-R258 ◽  
Author(s):  
Clare A Whicher ◽  
Hermione C Price ◽  
Richard I G Holt
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Physical Health ◽  
Causal Effect ◽  
Metabolic Effects ◽  
Improve Life Expectancy ◽  
Potential Risks ◽  
Mental And Physical Health

Objective There have been concerns about the effects of antipsychotics on weight gain and the development of type 2 diabetes (T2DM). This article aims to provide an up-to-date review on the evidence addressing this issue and the practical implications for the management of people taking antipsychotics in the context of T2DM. Methods We carried out searches on MEDLINE/PUBMED and the ClinicalTrials.gov website in August 2017 using the terms ‘antipsychotic’ and ‘diabetes’ or ‘glucose’ citing articles published after 2006 preferentially. Results Antipsychotics are associated with T2DM and are likely to exert a causal effect of uncertain magnitude. Children and adolescents appear especially vulnerable to these metabolic effects; as T2DM is not common in healthy younger people, the relative risk is more apparent. Antipsychotics act on glucose and insulin homeostasis in a variety of direct and indirect mechanisms. To reduce the increasing health inequalities among individuals with mental illness screening, monitoring and prevention of T2DM is important, as is improved diabetes care in this population. Conclusion It remains unclear whether these antipsychotic medications exacerbate an underlying predisposition to the development of T2DM or have a direct effect. Potential risks need to be weighed up and balanced between improved and lasting mental health benefits and any detrimental physical health side effects. Achieving parity of esteem between mental and physical health is a worldwide priority if we wish to improve life expectancy and quality of life in people with severe mental illness.

scholarly journals PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE AND RECOVERY AMONG OLDER ADULTS WITH SERIOUS MENTAL ILLNESS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S877-S877
Author(s):  
Anjana Muralidharan ◽  
Clayton H Brown ◽  
Richard W Goldberg
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Older Adults ◽  
Mental Illness ◽  
Physical Health ◽  
Serious Mental Illness ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Older adults with serious mental illness (i.e., schizophrenia spectrum disorders and affective psychoses) exhibit marked impairments across medical, cognitive, and psychiatric domains. The present study examined predictors of health-related quality-of-life and mental health recovery in this population. Participants (N=211) were ages 50 and older with a chart diagnosis of serious mental illness and a co-occurring medical condition, engaged in outpatient mental health services at a study site. Participants completed a battery of assessments including subtests from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the 24-Item Behavior and Symptom Identification Scale (BASIS-24), the 12-Item Short-Form Health Survey (SF-12), and the Maryland Assessment of Recovery Scale (MARS). Multiple linear regression analyses, with age, race, gender, and BMI as covariates, examined number of current medical conditions, RBANS, and BASIS as predictors of quality-of-life and recovery. Significant predictors of physical health-related quality-of-life (R-squared=.298, F(9,182)=8.57, p<.0001) were number of medical conditions (β=-1.70, p<.0001), BASIS-Depression/Functioning (β=-4.84, p<.0001), and BASIS-Psychosis (β=2.39, p<.0008). Significant predictors of mental health-related quality-of-life (R-squared=.575, F(9,182)=27.37, p<.0001) were RBANS (β=0.03, p=.05), BASIS-Depression/Functioning (β=-6.49, p<.0001), BASIS-Relationships (β=-3.17, p<.0001), and BASIS-Psychosis (β=-1.30, p=.03). Significant predictors of MARS (R-squared=.434, F(9,183)=15.56, p<.0001) were BASIS-Depression/Functioning (β=-4.68, p=.002) and BASIS-Relationships (β=-9.44, p<.0001). To promote holistic recovery among older adults with serious mental illness, integrated interventions are required. For example, to improve physical health-related quality-of-life, one should target depression and psychotic symptoms as well as medical illness burden. To improve mental health-related quality-of-life, depression symptoms and interpersonal functioning may be key targets, as well as neurocognitive function.

Establishing a physical health monitoring service for patients on depot antipsychotic medication

2016 ◽  
pp. 1-7 ◽  
Author(s):  
M. Gill ◽  
K. McKenna ◽  
M. McCauley ◽  
M. Gulzar
Keyword(s):  
Physical Health ◽  
Antipsychotic Medication ◽  
Health Monitoring ◽  
Blood Test ◽  
Best Practice ◽  
Premature Death ◽  
Physical Parameters ◽  
Blood Testing ◽  
Depot Antipsychotic ◽  
Long Acting

IntroductionPatients with major mental illness are recognised to be at risk of premature death for a multitude of reasons. This initiative aimed to improve the physical health monitoring of patients prescribed depot antipsychotic medication in a catchment area of ~36 000 in Ireland.ObjectivesInternational best practice recommends monitoring of blood tests, physical parameters such as weight, BMI, waist circumference and blood pressure, and side effects of patients prescribed antipsychotic medication. A clinic was established to target these interventions.MethodsA cohort of patients receiving antipsychotics in long-acting injectable form was chosen. A twice-yearly, multidisciplinary health monitoring clinic was established. Evaluation involved an audit of medical records which measured the proportion of those attending the clinic who had blood test monitoring and physical parameters recorded.ResultsBefore the clinic’s implementation, 30% of patients had evidence of some blood test monitoring, 9% had evidence of complete blood testing and one patient had evidence of physical health parameters having been recorded. One year after the implementation 78% of patients had evidence of some blood test monitoring, 61% had evidence of full blood test monitoring and 100% had evidence of physical parameters recorded.ConclusionsThe clinic was positively received by patients, and led to improved teamwork. Recommendations include organising concurrent psychiatric and phlebotomy clinics so that patients may avail of psychiatric review and blood testing at a single appointment. As a result of the increased focus on physical health monitoring, a similar project is planned to target all patients prescribed antipsychotics.

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