Who should swing the stethoscope? An audit of baseline physical examination and blood monitoring on new patients accepted by an early intervention in psychosis team.
OBJECTIVE
It has been established that patients with severe mental illness are at increased risk of physical illness and that physical health screening should be performed when an individual experiences a first episode of psychosis. The aim of the audit was to examine how physical health screening was achieved in the real world of an early intervention in psychosis (EIP) service in Scotland. Of particular interest was considering if primary or secondary care were more effective in providing specific physical health assessment for those presenting to the service.


METHODS
A case note audit was performed.


RESULTS
The audit shows that physical examination and blood tests were being completed in the majority of service users under the care of the Esteem service. However, an unacceptably high number were not undergoing sufficient initial screening for metabolic syndrome or having baseline monitoring prior to commencing antipsychotic medication.


CONCLUSIONS
Our results suggest that relying on primary care to provide physical health screening was not an effective approach in a population experiencing first-episode psychosis. Having a psychiatrist motivated to perform physical health screening within the EIP team may help to improve the uptake of physical health screening. Strategies to improve physical health screening in EIP services are discussed.
Department of Liaison Psychiatry, Southern General Hospital, Glasgow, UK.
Jim
J
Crabb
Mark
M
McAllister
Alison
A
Blair
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D061345:Early Medical Intervention / Q000379:methods*; D006403:Hematologic Tests / Q000706:statistics & numerical data*; D006801:Humans; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000517:prevention & control; D010348:Patient Care Team / Q000706:statistics & numerical data; D010808:Physical Examination / Q000706:statistics & numerical data*; D017064:Process Assessment, Health Care / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D012606:Scotland
D014150:Antipsychotic Agents