Guideline Adherence for Cardiometabolic Monitoring of Patients Prescribed Antipsychotic Medications in UK primary care: A Retrospective Observational study

Author:

Ali Ruba Saleh Azfr1ORCID,Jalal Zahraa2,Johal Jaspal3,Paudyal Vibhu2

Affiliation:

1. Umm Al-Qura University College of Pharmacy

2. University of Birmingham College of Medical and Dental Sciences

3. The Dudley Group NHS Foundation Trust

Abstract

Abstract Background The adverse effects of antipsychotics on cardiometabolic function are well documented despite their known effectiveness. Despite guidelines promoting routine monitoring, practices appear to be suboptimal. Aim The present study investigated the level of adherence to guidelines for cardiovascular and metabolic monitoring among healthcare professionals in primary care and factors that may influence monitoring patterns. Method Data were collected for patients with mental illness and prescribed antipsychotics at two general practices in England (February 2016-February 2021). The main outcome measures were the proportion of patients with evidence of monitoring for cardiometabolic parameters (body compositions, anthropometrics, lipids, glucose outcomes). Regression analysis was used to explore the factors predicting the monitoring practices. Results Data from 497 patients were included. The proportion of patients receiving cardiometabolic monitoring at least once yearly varied across different parameters. Patients were mostly monitored for BP (92%), body weight (BMI; >85%) and HDL (72%), but to a lesser extent for other lipid parameters (non-HDL ≈ 2%) and blood glucose (≈ 2%). Old age (OR:2.0–7.0, p < 0.001) and chronic conditions (e.g., CVD and DM, p < 0.05) were associated with cardiometabolic monitoring. Conversely, high metabolic risks antipsychotics (olanzapine), antipsychotic polypharmacy and cardiometabolic dysregulations (e.g., dyslipidaemias) did not improve monitoring practices. Conclusions Cardiometabolic health monitoring was generally infrequent, irregular, and did not change in response to abnormal test results or antipsychotic treatment with high cardiometabolic risks, suggesting more efforts need to be made to ensure the guidelines for cardiometabolic monitoring are followed. Monitoring Practices need to be evaluated across more general practices in the UK.

Publisher

Research Square Platform LLC

Reference24 articles.

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