title: Physical health of patients with severe mental illness: an intervention on medium secure forensic unit.
abstract: OBJECTIVE
  Patients with severe mental illness (SMI) treated with antipsychotic medication are at increased risk of metabolic side-effects like weight gain, diabetes mellitus and dyslipidaemia. This study aims to examine the feasibility of maintaining a physical health monitoring sheet in patients' records and its impact on physical health of patients with SMI, over a period of one year.
  
  
  METHODS
  A physical health monitoring sheet was introduced in all the patients' records on a 15-bedded male medium secure forensic psychiatric rehabilitation unit, as a prompt to regularly monitor physical health parameters. An audit cycle was completed over a one year period. The data between baseline and re-audit were compared.
  
  
  RESULTS
  At baseline, 80 per cent of the patients were identified as smokers, 80 per cent had increased body mass index (BMI) and 87 per cent had raised cardiovascular risk over the next ten years. Appropriate interventions were offered to address the risks. At re-audit, the physical health monitoring sheets were up to date in 100 per cent of patients' records. The serum lipids and cardiovascular risk over the next ten years reduced over time. No significant change was noted on the parameters including BMI, central obesity, high blood pressure and smoking status.
  
  
  CONCLUSIONS
  This was a pilot study and was limited by the small sample size, male gender only and the specific nature of the ward.
  
  
  CONCLUSIONS
  There is a need for improved access to physical health care in long-stay psychiatric settings. A more robust lifestyle modification programme is required to positively influence the physical health parameters in this cohort of patients.
  
  
  CONCLUSIONS
  Introduction of a physical health monitoring sheet in patients' records led to regular screening of cardiovascular risks and subsequent increased prescribing of hypolipidaemic agents in individuals with severe mental illness.
authors: London Health Sciences Centre, London, Canada. kamini.vasudev@lhsc.on.ca
authors: Kamini
authors: K
authors: Vasudev
authors: Pratish B
authors: PB
authors: Thakkar
authors: Nicola
authors: N
authors: Mitcheson
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000517:prevention & control; D016903:Drug Monitoring / Q000379:methods; D006304:Health Status; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy; D010865:Pilot Projects; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy*; D012907:Smoking / Q000009:adverse effects
chemical_list: D014150:Antipsychotic Agents; D008055:Lipids