Abstract
BackgroundPeople with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Routine metabolic monitoring is proposed as a method of identifying risk factors for metabolic abnormalities. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, however. This present study reports on the recent implementation of a routine metabolic monitoring form at a mental health service in regional Australia.MethodsA retrospective file audit was undertaken on 721 consumers with electronic health records at the mental health service. Descriptive statistics were used to report the frequency of use of the metabolic monitoring form and the range of metabolic parameters that had been recorded.ResultsConsumers had an average age of 41.4 years (SD = 14.6), over half were male (58.4 %), and the most common psychiatric diagnosis was schizophrenia (42.3 %). The metabolic monitoring forms of 36 % of consumers contained data. Measurements were most commonly recorded for weight (87.4 % of forms), height (85.4 %), blood pressure (83.5 %), and body mass index (73.6 %). Data were less frequently recorded for lipids (cholesterol, 56.3 %; low density lipoprotein, 48.7 %; high density lipoprotein, 51.7 %; triglycerides, 55.2 %), liver function (alanine aminotransferase, 66.3 %; aspartate aminotransferase, 65.5 %; gamma-glutamyl transpeptidase, 64.8 %), renal function (urea, 66.3 %; creatinine, 65.9 %), fasting blood glucose (60.2 %), and waist circumference (54.4 %).ConclusionsThe metabolic monitoring forms in consumer electronic health records are not utilised in a manner that maximises their potential. The extent of the missing data suggests that the metabolic health of most consumers may not have been adequately monitored. Addressing the possible reasons for the low completion rate has the potential to improve the provision of physical health care for people with mental illness.
Highlights
People with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population
This paper reports on metabolic monitoring in a regionally located public mental health service within a large state of Australia
Inadequate physical health care of people with severe mental illnesses (SMI) is acknowledged as a widespread issue [52]
Summary
People with severe mental illness have poorer physical health, experience disparities in physical health care, and lead significantly shorter lives, compared to the general population. Efforts to date suggest routine metabolic monitoring is both incomplete and ad-hoc, . People with severe mental illnesses (SMI) -such as schizophrenia, bipolar disorder, and major depressive disorder - have substantially poorer physical health than the general population [1, 2]. They are at increased risk of many physical health problems, including cardiovascular diseases, obesity, metabolic syndrome, and dyslipidaemia [1]. Health care providers, including mental health services, have an important role in identifying and monitoring these risks [11]
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