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Monitoring the physical health of psychiatric patients on psychotropic drugs

Knowsley Assertive Outreach Team, Prysmian Building, Hall Lane, Prescot L34 5WU, email: khalidsani{at}hotmail.com

Dr Tarrant highlights the risk of developing diabetes on antipsychotic medication and the need for monitoring of blood glucose (Psychiatric Bulletin, August 2006, 30, 286–288). Psychiatric patients also tend to have a higher prevalence of other independent predictors of cardiovascular disease, including smoking, hypertension, obesity, a sedentary lifestyle and hyperlipidaemia. There is plenty of room for improvement in monitoring the physical health of patients on antipsychotic treatment.

Who should be primarily responsible for such monitoring? The American Diabetes Association and others developed a measurement consensus statement that recommended the monitoring of weight, waist measurement, blood pressure, fasting glucose and lipids (American Diabetes Association et al, 2004). Does the responsibility fall mainly to our primary care colleagues or do we need to take a more active role? Do we need better facilities for monitoring in our in-patient and community clinics with involvement of our nursing and dietician colleagues?

Action needs to be taken when any results or measurements are abnormal. Results are often communicated to general practitioners by letter and can easily be overlooked. I wonder whether we need to start initiating treatment such as statins ourselves. This would require ongoing education in primary care medicine. Other possible measures include interventions to promote general healthy living and lifestyle changes, and weight management clinics.

References

AMERICAN DIABETES ASSOCIATION et al (2004) Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care, 27, 596 –601.[Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sani, K. Mohd. Search for Related Content PubMed Articles by Sani, K. Mohd.