scholarly journals Recovery from psychosis: physical health, antipsychotic medication and the daily dilemmas for mental health nurses

2015 ◽  
Vol 22 (7) ◽  
pp. 549-557 ◽  
Author(s):  
D. Bressington ◽  
J. White
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Antipsychotic Medication ◽  
Mental Health Nurses

scholarly journals Facilitating knowledge of mental health nurses to undertake physical health interventions: a pre-test/post-test evaluation

2014 ◽  
Vol 22 (3) ◽  
pp. 383-393 ◽  
Author(s):  
Steve Hemingway ◽  
Andrew Clifton ◽  
John Stephenson ◽  
Karen-Leigh Edward
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Interventions ◽  
Test Evaluation ◽  
Mental Health Nurses ◽  
Post Test

scholarly journals Switching antipsychotics to support the physical health of people with severe mental illness: a qualitative study of healthcare professionals’ perspectives

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042497
Author(s):  
Annabel Nash ◽  
Tom Kingstone ◽  
Saeed Farooq ◽  
Jessica Tunmore ◽  
Carolyn A Chew-Graham
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Side Effects ◽  
Qualitative Study ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Secondary Care ◽  
Healthcare Professionals ◽  
Mental Health Nurses

ObjectivesThe side effects of antipsychotic medications (APs) can increase the risk of developing physical health conditions. Some APs pose a higher risk than others. Evidence suggests switching to lower risk APs can support physical health outcomes. We sought to explore the views of healthcare professionals about switching antipsychotics to support physical health in people with severe mental illness (SMI).DesignA qualitative study with semi-structured interviews conducted with general practitioners (GPs), psychiatrists and mental health nurses. The main focus was to explore participants’ views on the physical health of people with SMI, the impact of APs and decision-making about switching medication to support physical health. Data were analysed thematically using principles of constant comparison.SettingsParticipants recruited through primary care and one mental health trust in the West Midlands.ParticipantsInterviews were conducted with 9 GPs, 10 psychiatrists and 4 mental health nurses.ResultsAwareness and knowledge of AP side-effects and risk profiles varied considerably between primary and secondary care clinicians. GPs reported limited awareness, while psychiatrists and nurses demonstrated a comprehensive understanding of AP risk profiles and side-effects. Mental health and control of symptoms were prioritised. Switching to promote physical health was considered as a reactive intervention, once side-effects or complications developed. There were a range of views over where responsibility lay for monitoring physical health and consideration of switching. Collaboration between primary and secondary care was identified as a way to address this.ConclusionsThis study presents multidisciplinary perspectives on awareness, decision making, perceived responsibility and barriers to switching APs to support physical health. Collaborative approaches that involve liaison between primary and secondary care, but tailored to the individual patient, may support switching, and present an opportunity to intervene to address the physical health inequalities experienced by individuals with SMI.

scholarly journals Mind and body: physical health monitoring in clozapine treatment

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S168-S168
Author(s):  
Moataz Abdelreheem ◽  
Olivia Connell ◽  
Daniel McNally ◽  
Itunuayo Veronica Ayeni ◽  
Clare Smith
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Physical Health ◽  
Antipsychotic Medication ◽  
Health Monitoring ◽  
Blood Count ◽  
Full Blood Count ◽  
Clozapine Treatment ◽  
Health Review

AimsTo evaluate physical health monitoring standards in patients on Clozapine in the community.StandardsNICE and BNF guidelines for patients on established clozapine treatment advise annual monitoring of weight, waist circumference, pulse, blood pressure, fasting blood glucose, HbA1c, blood lipids and overall physical health assessment. Full blood count is monitored 1-4 weekly.BackgroundIn the management of schizophrenia, antipsychotic medication remains the cornerstone of treatment. Patients affected carry a significant physical health burden with a reduced life expectancy of 10-25 years. Factors that contribute include sedentary lifestyles, consequent obesity and cardiovascular disease, disengagement from health services, a higher incidence of suicide and the physical side effects of antipsychotic medication. For these reasons, comprehensive routine physical assessment of patients on antipsychotic treatment is of central importance.MethodThis audit is a retrospective study of patients known to South Kensington & Chelsea Community Mental Health Team (CMHT). Patients (n = 48) were audited from the Clozapine clinic SystemOne database over a one year period (October 2018-2019) to assess annual monitoring of full blood count (FBC), urea and electrolytes (U&Es), lipid profile, liver function tests (LFTs), HbA1C, thyroid function tests (TFTs), clozapine levels, ECG, and general physical and mental health review.ResultOf the 48 patients, one was transferred to a different service so was excluded (n = 47 total).All (100.0%) of the patients had annual FBC tests. All but one (97.9%) of the patients had a physical health review including blood pressure, pulse, weight and BMI measurement. Three quarters (74.5%) received annual U&Es and LFTs. Almost two thirds of patients had annual lipid and HBA1c screening (63.8%) and over half the cohort had annual TFTs (61.7%). Regarding annual multidisciplinary mental health review, this was performed for the majority of the patients (70.2%).Contrastingly, only a quarter of the patients received annual screening of glucose and Clozapine levels (27.7% for both). Only 12 patients had annual ECG (25.5%).ConclusionFollowing review it is clear that most parameters were monitored annually in a majority of patients. However, shortcomings were detected, specifically annual ECG and waist circumference monitoring.In order to ensure comprehensive monitoring of mental and physical health of patients on Clozapine, flow charts of tests and reviews needed for each patient were written up clearly and will be included in the management pathway for every patient on Clozapine. This was agreed to minimise missing any step, particularly annual ECGs.

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