Screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics: a quality improvement programme.
OBJECTIVE
The aim was to evaluate a quality improvement programme designed to increase screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics.


METHODS
Baseline audit against evidence-based standards, followed by provision of benchmarked data and a range of change interventions, with re-audit 1 year later.


RESULTS
At baseline, 48 assertive outreach teams across the UK submitted data on screening over the previous year for 1966 patients. At re-audit, 35 of the teams submitted data for 1516 patients. Screening for all four aspects of the metabolic syndrome (measuring blood pressure, obesity, blood glucose and plasma lipids) had increased significantly by re-audit. Clinical variables increasing the likelihood of full screening were clozapine treatment and a known diagnosis of diabetes or dyslipidaemia.


CONCLUSIONS
The programme's success may be partly attributed to the use of a widely-accepted audit standard, and bespoke change interventions that directly addressed barriers to screening identified by the participating clinical teams.
Barnes
T R E
TR
Department of Psychological Medicine, Imperial College Faculty of Medicine, Charing Cross Campus, London, UK. t.r.barnes@imperial.ac.uk
Paton
C
C
Hancock
E
E
Cavanagh
M-R
MR
Taylor
D
D
Lelliott
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019985:Benchmarking / Q000592:standards; D001835:Body Weight / Q000187:drug effects; D003156:Community Mental Health Services / Q000592:standards; D003159:Community-Institutional Relations / Q000592:standards; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004739:England; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008485:Medical Audit / Q000592:standards; D024821:Metabolic Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010808:Physical Examination; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D011785:Quality Assurance, Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards; D012015:Reference Standards; D017010:Reminder Systems; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D014150:Antipsychotic Agents