Use of an electronic metabolic monitoring form in a mental health service - a retrospective file audit.
BACKGROUND
People with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Routine metabolic monitoring is proposed as a method of identifying risk factors for metabolic abnormalities. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, however. This present study reports on the recent implementation of a routine metabolic monitoring form at a mental health service in regional Australia.


METHODS
A retrospective file audit was undertaken on 721 consumers with electronic health records at the mental health service. Descriptive statistics were used to report the frequency of use of the metabolic monitoring form and the range of metabolic parameters that had been recorded.


RESULTS
Consumers had an average age of 41.4 years (SD = 14.6), over half were male (58.4%), and the most common psychiatric diagnosis was schizophrenia (42.3%). The metabolic monitoring forms of 36% of consumers contained data. Measurements were most commonly recorded for weight (87.4% of forms), height (85.4%), blood pressure (83.5%), and body mass index (73.6%). Data were less frequently recorded for lipids (cholesterol, 56.3%; low density lipoprotein, 48.7%; high density lipoprotein, 51.7%; triglycerides, 55.2%), liver function (alanine aminotransferase, 66.3%; aspartate aminotransferase, 65.5%; gamma-glutamyl transpeptidase, 64.8%), renal function (urea, 66.3%; creatinine, 65.9%), fasting blood glucose (60.2%), and waist circumference (54.4%).


CONCLUSIONS
The metabolic monitoring forms in consumer electronic health records are not utilised in a manner that maximises their potential. The extent of the missing data suggests that the metabolic health of most consumers may not have been adequately monitored. Addressing the possible reasons for the low completion rate has the potential to improve the provision of physical health care for people with mental illness.
Synergy, Nursing and Midwifery Research Centre University of Canberra, Faculty of Health and ACT Health, Canberra, Australia.
Brenda
B
Happell
Synergy, Nursing and Midwifery Research Centre University of Canberra, Faculty of Health and ACT Health, Canberra, Australia.
Chris
C
Platania-Phung
School of Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, QLD, 4702, Australia.|Gaskin Research, Melbourne, Australia.
Cadeyrn J
CJ
Gaskin
School of Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, QLD, 4702, Australia. r.stanton@cqu.edu.au.
Robert
R
Stanton
D000328:Adult; D000368:Aged; D001315:Australia; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D001523:Mental Disorders / Q000150:complications* / Q000175:diagnosis; D008605:Mental Health Services / Q000458:organization & administration*; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D055105:Waist Circumference
Cardiometabolic; Mental health service; Monitoring; Physical health; Severe mental illness