Monitoring weight and blood glucose in in-patients: how helpful is a protocol?

Runcie, Olga; Boilson, Marie; Hamilton, Ross

doi:10.1192/pb.bp.105.005934

Cited by 9 publications

(19 citation statements)

References 11 publications

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“…Direct impact of pharmacist was not reported in the findings. Runcie, 2007, UK [ 100 ] Impact of a protocol for monitoring weight and blood glucose in psychiatric inpatients receiving antipsychotics. Hospital pharmacist.…”

Section: Resultsmentioning

confidence: 99%

“…The mapping review included all 33 studies (quantitative, qualitative and mixed methods). Figure 2 shows the key components of the healthcare pathway for CMR, MetS and related diseases and the role of pharmacy at each key component; fourteen studies [ 73 , 79 – 81 , 83 , 84 , 86 , 87 , 89 – 91 , 93 , 100 , 102 ] included pharmacists in more than one key component. Twenty-seven [ 75 , 79 – 81 , 83 , 84 , 86 , 87 , 89 – 91 , 93 – 95 , 97 – 102 , 104 ] of the 33 studies included direct (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…The randomised controlled study [84] identified for this review scored poorly (25%) due to lack of description of participant allocation, < 80% reporting of outcome data and a high rate participant attrition (> 20%). Quasi experimental approaches were utilised in thirteen [86,88,92,94,95,[97][98][99][100][101][102][103][104] of the quantitative, outcome studies, (n=12) [86, 88, 92, 94, 95, 97-101, 103, 104] of these scored more than 50%. Seventy-one percent [71,85,87,90,91,93] (n = 5) of the quantitative descriptive studies scored 50% or more.…”

Section: Summary Of Quality Assessmentmentioning

confidence: 99%

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The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

et al. 2021

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Background Individuals with severe mental illness, e.g. schizophrenia have up to a 20% shortened life expectancy compared to the general population. Cardiovascular disease, due to cardiometabolic risk and metabolic syndrome, accounts for most of this excess mortality. A scoping search revealed that there has not been a review of published studies on the role of pharmacy in relation to cardiometabolic risk, metabolic syndrome and related diseases (e.g. type 2 diabetes) in individuals with severe mental illness. Methods A mixed-methods systematic review was performed. Eleven databases were searched using a comprehensive search strategy to identify English-language studies where pharmacy was involved in an intervention for cardiometabolic risk, metabolic syndrome or related diseases in severe mental illness in any study setting from any country of origin. First, a mapping review was conducted. Then, implementation strategies used to implement the study intervention were classified using the Cochrane Effective Practice and Organisation of Care Taxonomy. Impact of the study intervention on the process (e.g. rate of diagnosis of metabolic syndrome) and clinical (e.g. diabetic control) outcomes were analysed where possible (statistical tests of significance obtained for quantitative outcome parameters reported). Quality assessment was undertaken using a modified Mixed Methods Appraisal Tool. Results A total of 33 studies were identified. Studies were heterogeneous for all characteristics. A total of 20 studies reported quantitative outcome data that allowed for detailed analysis of the impact of the study intervention. The relationship between the total number of implementation strategies used and impact on outcomes measured is unclear. Inclusion of face-to-face interaction in implementation of interventions appears to be important in having a statistically significantly positive impact on measured outcomes even when used on its own. Few studies included pharmacy staff in community or general practitioner practices (n = 2), clinical outcomes, follow up of individuals after implementation of interventions (n = 3). No studies included synthesis of qualitative data. Conclusions Our findings indicate that implementation strategies involving face-to-face interaction of pharmacists with other members of the multidisciplinary team can improve process outcomes when used as the sole strategy. Further work is needed on clinical outcomes (e.g. cardiovascular risk reduction), role of community pharmacy and qualitative studies. Systematic review registration PROSPERO CRD42018086411

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of Quality Assessmentmentioning

confidence: 99%

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The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

et al. 2021

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“…Guidelines have the potential to “improve the care received by patients by promoting interventions of proven benefit” and to “inform clinical practice, promoting effective and cost effective health care”, 20 yet current guidelines for metabolic screening in this patient population seem to have had little impact on clinical practice or patient outcomes. Although clinicians may be aware of published guidelines and may receive personal reminders by mail to undertake monitoring, it still does not occur consistently in either inpatient or outpatient settings 21 , 22 . It is worth noting, however, that the mandating of haematological and cardiac monitoring of patients prescribed clozapine has resulted in improved rates of metabolic monitoring of these patients 21 , 23 …”

Section: “Real World” Monitoringmentioning

confidence: 99%

Screening for the metabolic syndrome in patients receiving antipsychotic treatment: a proposed algorithm

Waterreus

Laugharne

2009

Medical Journal of Australia

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The metabolic syndrome (MetS) is a well described cluster of interrelated risk factors for developing cardiovascular disease and type 2 diabetes. The key components of MetS are central obesity, hypertension, hyperglycaemia and dyslipidaemia. The 2005 International Diabetes Federation (IDF) consensus definition of MetS aimed to reduce confusion over criteria for MetS and to provide a simple diagnostic and clinical tool. There is considerable evidence to show that patients prescribed antipsychotic drugs are at increased risk of developing MetS. Existing clinical guidelines for metabolic screening of patients taking antipsychotics focus on diabetes rather than on the broader syndrome of MetS and are not consistent with the IDF definition of MetS. Monitoring for MetS in patients taking antipsychotics (both inpatients and outpatients) is generally poor. We present a user‐friendly clinical algorithm and monitoring form, based on current evidence and using the IDF definition of MetS, to help clinicians in primary care or specialist settings to effectively monitor for MetS in these patients.

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“…These protocols are consensus- and not evidence-based, this being one possible reason for the variance in clinical practice, which has been documented 6 7…”

Section: Outline Of Problemmentioning

confidence: 99%