Does training practice nurses to carry out physical health checks for people with severe mental illness increase the level of screening for cardiovascular risk?

Abstract

Compared to the general population, people with severe mental illness (SMI) have a higher risk of developing cardiovascular disease (CVD). Authors of clinical guidelines advise annual screening for CVD risk factors with appropriate lifestyle counselling. There are seven recommended elements of this health check: blood pressure, body mass index (or waist circumference), blood glucose, serum cholesterol, diet advice, exercise recommendations and smoking cessation guidance. To establish whether training practice nurses increases the proportion of patients with SMI who are screened for CVD risk factors and given lifestyle advice in primary care. A before-and-after audit of 400 patients on the SMI registers in five primary care centres in Northampton, England. Following the training, the proportion of patients with SMI who received all elements of the health check significantly increased (pre-training: n = 33, 8%, 95% CI = 6-11; post-training: n = 60, 15%, 95% CI = 12-19; RR = 1.82, 95% CI = 1.22-2.72, p = .01). Training practice nurses about CVD prevention in people with SMI may be effective in increasing the proportion of patients in this group who receive a comprehensive health check.