An evaluation of monitoring practices in patients on second generation antipsychotics.
OBJECTIVE
Treatment with second generation antipsychotics (SGAs) can increase the risk of patients with schizophrenia developing obesity, hyperlipidaemia and diabetes. Routine monitoring is recommended, but clinical practice suggests monitoring is not conducted at a rate necessary for these comorbidities. The aim was to audit what proportion of patients were having their weight, height, girth, body mass index, lipids and blood sugar levels monitored and recorded.


METHODS
An audit of patients with schizophrenia, discharged from three psychiatric wards, was conducted. Two data sheets were recorded for every patient and inter-rater reliability was calculated. Data were then entered into SPSS and statistical significance calculated.


RESULTS
The sample consisted of 93 patients; SGAs were taken by 31% of admitted and 88% of discharged patients. Of these, 65% had their weight recorded, 61% height, 31% random blood sugar levels, 3% postprandial blood sugar levels, 2% glycosylated haemoglobin, and 7.5% cholesterol and triglycerides. Girth and BMI were not recorded. Abnormalities were detected in 29% of recorded BSL and 2% of recorded cholesterol.


CONCLUSIONS
Patients with schizophrenia on antipsychotics have an alarmingly low rate of monitoring of these common adverse effects and comorbidities. Clinicians need to be aware of this, so that they can improve their practice.
Nguyen
Dang
D
Discipline of Psychological Medicine and Western Clinical School, University of Sydney, Westmead, NSW, Australia. dang_nguyen9@yahoo.com.au
Brakoulias
Vlasios
V
Boyce
Philip
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D015992:Body Mass Index; D003627:Data Interpretation, Statistical; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced; D005260:Female; D017408:Guidelines as Topic; D006778:Hospitals, Psychiatric; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000139:chemically induced; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009517:New South Wales / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000139:chemically induced; D015588:Observer Variation; D011618:Psychotic Disorders / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy; D055815:Young Adult
D014150:Antipsychotic Agents; D001786:Blood Glucose; D008055:Lipids