Transmural collaborative care model for the review of antipsychotics: a feasibility study of a complex intervention

Author:

Jakobs Kirsti M.1,Brule-Barnhoorn Karlijn J. van den1,Lieshout Jan van2,Janzing Joost G.E.3,Cahn Wiepke3,Muijsenbergh Maria van den1,Biermans Marion C.J.1,Bischoff Erik W.M.A.1

Affiliation:

1. Radboud University Nijmegen Medical Centre

2. IQ healthcare

3. Psychiatry UMC Utrecht

Abstract

Abstract General practitioners (GPs) are often unaware of antipsychotic (AP)-induced cardiovascular risk (CVR) and therefore patients using atypical APs are not systematically monitored. We evaluated the feasibility of a complex intervention designed to review the use of APs and advise on CVR-lowering strategies in a transmural collaboration. A mixed methods prospective cohort study in three general practices in the Netherlands was conducted in 2021. The intervention comprised three steps: a digital information meeting, a multidisciplinary meeting, and a shared decision-making visit to the GP. We assessed patient recruitment and retention rates, advice given and adopted, and CVR with QRISK3 score and mental state with MHI-5 at baseline and three months post-intervention. GPs invited 57 of 146 eligible patients (39%), of whom 28 (19%) participated. The intervention was completed by 23 (82%) and follow-up by 18 participants (64%). At the multidisciplinary meeting, 22 (78%) patients were advised to change AP use. Other advice concerned medication (other than APs), lifestyle, monitoring, and psychotherapy. At 3-months post-intervention, 41% (28/68) of this advice was adopted. Our findings suggest that this complex intervention is feasible for evaluating health improvement in patients using AP in a trial.

Publisher

Research Square Platform LLC

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