title: Evaluation of a general practitioner-led cardiometabolic clinic: Physical health profile and treatment outcomes for clients on clozapine.
abstract: The present study is a review of a cardiometabolic clinic for consumers taking clozapine. This clinic was recently established and co-located with the clozapine clinic at a regional hospital in New South Wales, Australia, to enhance engagement and improve the physical health outcomes of consumers taking antipsychotic medication. A descriptive analysis of clients' (n = 73) information collected during routine care for the first 6 months of the clinic's operation, from January 2016 to July 2016, was conducted. First-visit data were analysed to establish a client profile, consisting of weight, height, blood pressure, pulse, a range of blood measurements, smoking status, alcohol consumption, and eating and exercise habits. Data collected for clients who had three or more visits with the general practitioner (n = 40) were analysed separately for outcomes. Two case studies are used to depict the service received and client profile. At the first appointment, the majority of clients had metabolic syndrome that was mostly left untreated; many of these clients were commenced on metformin. The outcomes are positive, and show that the majority of clients lost weight (82.5%) and had a reduction in body mass index (84.6%); nearly half (44.4%) had a reduction in waist circumference. The majority of clients self-reported increased physical activity (72.5%, n = 29) and positive dietary changes (77.5%, n = 31) since their first appointment. The model trialled by the cardiometabolic clinic integrated a specialist mental health and primary care service, and demonstrates success in engaging clients with severe mental illness in physical health care. Co-location is conceptualized as critical for positive patient outcomes and high levels of engagement.
authors.affiliation: Central Coast Local Health District, Central Coast Mental Health, Gosford, New South Wales, Australia.
authors.forename: Dominiek
authors.initials: D
authors.lastname: Coates
authors.affiliation: Central Coast Local Health District, Central Coast Mental Health, Gosford, New South Wales, Australia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Woodford
authors.affiliation: Central Coast Local Health District, Central Coast Mental Health, Gosford, New South Wales, Australia.
authors.forename: Oliver
authors.initials: O
authors.lastname: Higgins
authors.affiliation: Central Coast Local Health District, Central Coast Mental Health, Gosford, New South Wales, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Grover
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000517:prevention & control*; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D058005:General Practitioners; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D009517:New South Wales; D015397:Program Evaluation; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs; D003024:Clozapine
keywords: antipsychotic medication; clozapine; metabolic syndrome