Lipid profile screening in second-generation antipsychotic users: the gap between policy and practice

Morrato, Elaine H.; Hartung, Daniel

doi:10.2217/clp.10.29

Cited by 2 publications

(2 citation statements)

References 40 publications

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“…These factors included age, pre-existing metabolic conditions, CVD family history, risk of CVD and diabetes, and corresponding treatments. Frequent cardiometabolic monitoring related to age has been generally observed in related investigations [ 17 , 18 ]. Yet, evidence addressing factors affecting cardiometabolic monitoring performance in primary mental health services is limited.…”

Section: Discussionmentioning

confidence: 99%

Guideline adherence for cardiometabolic monitoring of patients prescribed antipsychotic medications in primary care: a retrospective observational study

Ali,

Jalal,

Johal

et al. 2023

Int J Clin Pharm

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Background Despite their known effectiveness, antipsychotics possess significant cardiometabolic adverse event profiles. Guidelines emphasise routine monitoring, however, practices are known to be suboptimal. Aim To investigate the level of cardiometabolic monitoring among people prescribed antipsychotic therapy in primary care, and patient-related factors that may influence monitoring patterns. Method Data were collected for patients with mental disorders and prescribed antipsychotics at two general practices in England (February 2016–February 2021). The main outcome measures were the proportion of patients with evidence of monitoring for cardiometabolic parameters (body composition, anthropometrics, lipids, glucose outcomes). Regression analysis was used to explore factors predicting monitoring practices. Results Data from 497 patients were included. The proportion of patients receiving cardiometabolic monitoring at least once yearly varied across different parameters. Patients were mostly monitored for BP (92.0%), body weight (BMI > 85.0%) and HDL (72.0%), but to a lesser extent for other lipid parameters (non-HDL < 2.0%) and blood glucose (< 2.0%). Ageing (OR:2.0–7.0, p < 0.001) and chronic conditions (e.g., CVD and Type 2 DM, p < 0.05) were associated with frequent cardiometabolic monitoring. Conversely, antipsychotics with high metabolic risks (olanzapine), patients prescribed antipsychotic polypharmacy (≥ 2 antipsychotics) and cardiometabolic dysregulations (e.g., dyslipidaemias) did not improve monitoring frequencies. Conclusion Cardiometabolic health monitoring was generally infrequent, irregular, and did not change in response to abnormal test results or antipsychotic treatment with high cardiometabolic risks, suggesting more efforts need to be made to ensure the guidelines for cardiometabolic monitoring are followed. Future studies should investigate practices by using a large UK primary care database.

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Section: Discussionmentioning

confidence: 99%

Guideline adherence for cardiometabolic monitoring of patients prescribed antipsychotic medications in primary care: a retrospective observational study

Ali,

Jalal,

Johal

et al. 2023

Int J Clin Pharm

View full text Add to dashboard Cite

show abstract

“…These factors included age, pre-existing metabolic conditions, CVD family history, risk of CVD and diabetes, and corresponding treatments. Frequent cardiometabolic monitoring related to age has been generally observed in related investigations [16,17]. Yet, evidence addressing factors affecting the performance of cardiometabolic monitoring in primary mental health services is limited.…”

Section: Key Ndingsmentioning

confidence: 99%

Guideline Adherence for Cardiometabolic Monitoring of Patients Prescribed Antipsychotic Medications in UK primary care: A Retrospective Observational study

Ali

Jalal

Johal

et al. 2023

Preprint

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Background The adverse effects of antipsychotics on cardiometabolic function are well documented despite their known effectiveness. Despite guidelines promoting routine monitoring, practices appear to be suboptimal. Aim The present study investigated the level of adherence to guidelines for cardiovascular and metabolic monitoring among healthcare professionals in primary care and factors that may influence monitoring patterns. Method Data were collected for patients with mental illness and prescribed antipsychotics at two general practices in England (February 2016-February 2021). The main outcome measures were the proportion of patients with evidence of monitoring for cardiometabolic parameters (body compositions, anthropometrics, lipids, glucose outcomes). Regression analysis was used to explore the factors predicting the monitoring practices. Results Data from 497 patients were included. The proportion of patients receiving cardiometabolic monitoring at least once yearly varied across different parameters. Patients were mostly monitored for BP (92%), body weight (BMI; >85%) and HDL (72%), but to a lesser extent for other lipid parameters (non-HDL ≈ 2%) and blood glucose (≈ 2%). Old age (OR:2.0–7.0, p < 0.001) and chronic conditions (e.g., CVD and DM, p < 0.05) were associated with cardiometabolic monitoring. Conversely, high metabolic risks antipsychotics (olanzapine), antipsychotic polypharmacy and cardiometabolic dysregulations (e.g., dyslipidaemias) did not improve monitoring practices. Conclusions Cardiometabolic health monitoring was generally infrequent, irregular, and did not change in response to abnormal test results or antipsychotic treatment with high cardiometabolic risks, suggesting more efforts need to be made to ensure the guidelines for cardiometabolic monitoring are followed. Monitoring Practices need to be evaluated across more general practices in the UK.

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Lipid profile screening in second-generation antipsychotic users: the gap between policy and practice

Cited by 2 publications

References 40 publications

Guideline adherence for cardiometabolic monitoring of patients prescribed antipsychotic medications in primary care: a retrospective observational study

Guideline adherence for cardiometabolic monitoring of patients prescribed antipsychotic medications in primary care: a retrospective observational study

Guideline Adherence for Cardiometabolic Monitoring of Patients Prescribed Antipsychotic Medications in UK primary care: A Retrospective Observational study

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