Persistent Low Rates of Treatment of Metabolic Risk Factors in People With Psychotic Disorders

Bruins, Jojanneke; Pijnenborg, Gerdina; Heuvel, Edwin R. van den; Visser, Ellen; Corpeleijn, Eva; Bartels-Velthuis, Agna A.; Bruggeman, Richard; Jörg, Frederike

doi:10.4088/jcp.16m10831

Cited by 26 publications

(26 citation statements)

References 39 publications

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“…In total 42.8% of all patients with a diagnosis in the psychosis spectrum in care at four mental healthcare institutions participated in the PHAMOUS study in the year VICTROM was added [31]. Of this group 65.9% (n = 581) completed the victimization survey during the 9-months study period.…”

Section: Resultsmentioning

confidence: 99%

“Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder

et al. 2019

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Introduction Although people with a psychotic disorder are approximately four to six times more often victimized than the general population, victimization is not routinely assessed in mental healthcare. This study investigates prevalence, context and risk factors of victimization in patients with a psychotic disorder in the Northern, relatively rural region of the Netherlands. Moreover, disclosure rates and awareness of psychiatrists are examined. Method Information on personal crime (threats, assaults and sexual violence), property and other forms of crime, the context of victimization and disclosure was routinely assessed in 353 patients with a psychotic disorder who received care at a mental health facility. In addition, involved psychiatrists reported on last year’s victimization incidents in their patients. Results One third of the patients reported victimization in the previous year. More than half of the crimes were committed by someone acquainted and took place in the victim’s own home or a place familiar to the victim. Younger age, having a comorbid disorder, drug use and perpetration of a crime were all positively associated with victimization. Approximately half of the reported personal crimes were disclosed to a health care professional but only in 16% of the cases the involved psychiatrist report to know about the incident. Conclusion This study confirms that people with a history of psychosis have an increased risk of becoming the victim of a crime. Although our results suggest that in fifty percent of cases the patients did share the information with professionals, a substantial proportion of incidents appear to go still unnoticed.

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Section: Resultsmentioning

confidence: 99%

“Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder

et al. 2019

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“…However, it was beyond the scope of this study to ascertain the rate of follow-up actions. Therefore, a future study is now required to demonstrate that the HIP-F has utility beyond establishing risk factors/recommending actions, i.e., that it results in actual changes in patients' behaviour, treatment and physical health state [72]. Therefore, in order to more conclusively demonstrate the clinical utility and efficacy of the HIP-F, future prospective studies should compare the outcomes of patients who have completed the HIP-F with those engaged in treatment as usual using a randomised controlled clinical trial.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Finnish Health Improvement Profile (HIP) with patients with severe mental illness

et al. 2020

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Background: Physical health among people with severe mental illness (SMI) is a global concern. However, many people with SMI do not receive regular comprehensive health checks. There is currently no validated physical health check instrument systematically used in Finnish mental health services. Therefore, this study aims to validate and establish the potential clinical utility of the translated Health Improvement Profile (HIP) tool for Finnish patients with SMI and compare differences in physical health risk items across genders. Methods: The content validity of the two-way translated Finnish HIP (HIP-F) was evaluated by five nurses and four patients with SMI using cognitive debriefing (to assess the clarity and relevance of each item and the recommended actions of the HIP tool). The potential clinical utility was assessed using a pilot test involving 47 patients. The prevalence of red-flagged (risk) items in the whole sample, across female and male participants, and the frequencies of any type of missing item response were calculated and analysed using descriptive statistics. A chi-square test was used to determine differences in frequencies of red-flagged items across genders. Results: Based on the cognitive debriefing, the HIP-F was found to have moderate content validity regarding the clarity and relevance of the items and recommended actions (the average scale level content validity index, S-CVI/ Ave, 0.74). In the pilot test, some missing item responses were identified, but in the sample, nurses identified 399 areas of health and health behaviour risks (mean 8.6 per patient) using the HIP-F. The most frequently red-flagged items were body mass index (BMI) and waist circumference (83.0%), smoking status (48.9%) and lipid levels (46.8%). Female patients had a higher frequency of red-flagged items than males in BMI (92.6% vs. 70.0%, p = 0.04) and waist circumference (96.3% vs. 65.0%, p = 0.01). Conclusions: The results demonstrate that the Finnish HIP has moderate content validity and preliminary clinical utility for evaluating the physical health and health behaviours of people with SMI. The HIP-F findings help to signpost evidence-based interventions for identified areas of concern. Additional nurse training may be necessary to realise the potential clinical utility of the tool in Finland.

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“…Body Mass Index (BMI), blood pressure, estimated Glomerular Filtration Rate (eGFR), smoking status, fasting glucose, lipid spectrum, use of alcohol, family history of cardiovascular disease) [ 43 ]. However, considering the observational nature of this study and screening criteria described in previous studies [ 29 , 30 ], we included a broader range of assessments (Additional file 1 : Appendix A1).…”

Section: Methodsmentioning

confidence: 99%

Cardiovascular risk screening of patients with serious mental illness or use of antipsychotics in family practice

Jakobs¹,

Posthuma²,

Grauw³

et al. 2020

BMC Fam Pract

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Background Patients with serious mental illness (SMI) and patients on antipsychotics (AP) have an elevated risk for cardiovascular diseases. In the Netherlands, the mental healthcare for these patients is increasingly taken care of by family practitioners (FP) as a result of a shift from secondary to primary care. Therefore, it is essential to increase our knowledge regarding the characteristics of this patient group and the (somatic) care provided by their FPs. The aim was to examine the rate of cardiovascular risk screening in patients with SMI or the use of AP in family practice. Methods We performed a retrospective cohort study of 151.238 patients listed in 24 family practices in the Netherlands. From electronic medical records we extracted data concerning diagnoses, measurement values of CVR factors, medication and frequency of visits over a 2 year period. Primary outcome was the rate of patients who were screened for CVR factors. We compared three groups: patients with SMI/AP without diabetes or CVD (SMI/AP-only), patients with SMI/AP and diabetes mellitus (SMI/AP + DM), patients with SMI/AP and a history of cardiovascular disease (SMI/AP + CVD). We explored factors associated with adequate screening using multilevel logistic regression. Results We identified 1705 patients with SMI/AP, 834 with a SMI diagnosis, 1150 using AP. The screening rate for CVR in the SMI/AP-only group ( n = 1383) was adequate in 8.5%. Screening was higher in the SMI/AP − +DM ( n = 206, 68.4% adequate, OR 24.6 (95%CI, 17.3–35.1) and SMI/AP + CVD ( n = 116, 26.7% adequate, OR 4.2 (95%CI, 2.7–6.6). A high frequency of visits, age, the use of AP and a diagnosis of COPD were associated with a higher screening rate. In addition we also examined differences between patients with SMI and patients using AP without SMI. Conclusion CVR screening in patients with SMI/AP is performed poorly in Dutch family practices. Acceptable screening rates were found only among SMI/AP patients with diabetes mellitus as comorbidity. The finding of a large group of AP users without a SMI diagnosis may indicate that FPs often prescribe AP off-label, lack information about the diagnosis, or use the wrong code.

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Persistent Low Rates of Treatment of Metabolic Risk Factors in People With Psychotic Disorders

Abstract: Metabolic risk factors are still seriously undertreated in people with psychotic disorders. Better adherence to and better implementation of guidelines about monitoring and treating metabolic disorders in psychiatry are crucial.

Cited by 26 publications

References 39 publications

“Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder

“Please tell me what happened”: A descriptive study on prevalence, disclosure and characteristics of victimization in people with a psychotic disorder

Validation of the Finnish Health Improvement Profile (HIP) with patients with severe mental illness

Cardiovascular risk screening of patients with serious mental illness or use of antipsychotics in family practice

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