Outreach visits by clinical pharmacists improve screening for the metabolic syndrome among mentally ill patients

Abstract

Background: Patients suffering from schizophrenia and affective disorder have an increased risk of the metabolic syndrome (MeS); hence identification of patients developing MeS may help preventing morbidity and mortality. Aims: The aim of the study was to evaluate the effect of outreach visit by clinical pharmacists to support the implementation of screening of MeS at a psychiatric ward. Methods: The study was conducted at the psychiatric ward, Odense University Hospital. In 2008, clinical guidelines for systematic screening and prevention of metabolic risk were developed and implemented by passive dissemination (PD) followed by a period of active implementation (AI). AI contained outreach visits by clinical pharmacists on a weekly basis. Patients with affective disorder or schizophrenia were included. The study was designed as a before-and-after study, and electronic patient charts were used for assessment of adherence to the clinical guidelines. Results: In total, 205 patients were included in the study (93 patients in the PD group, 112 patients in the AI group). A significant improvement of the use of the screening sheet from 36% in the PD group to 81% in the AI group was found (p < 0.001). Consequently, the quality of the screening increased significantly resulting in 45% in the AI group being identified with MeS compared with 10% in the PD group (p < 0.001). Conclusion: The outreach visits by clinical pharmacists significantly improved the use of the screening sheet and resulted in a significant increase in the proportion of patients identified with MeS (p < 0.001). Clinical implications: The increase in the use of a screening sheet for MeS among patients admitted to a psychiatric ward as a result of outreach visits by clinical pharmacist improve assessment for MeS. This may lead to better identification of patients suffering from MeS and hence increase the possibility of treating MeS and preventing morbidity and mortaligy.