Retrospective chart review of metabolic screening of patients receiving clozapine and long-acting injectable antipsychotic medications

Abstract

Background/Aims Individuals treated with antipsychotic medications are at risk of developing metabolic syndrome, negatively impacting the quality of life among patients with severe mental illness. The aim of this study was to examine metabolic screening data and determine the prevalence of metabolic syndrome among those who were prescribed clozapine and long-acting injectable antipsychotics. Methods This retrospective chart review looked at 307 patient records who were prescribed clozapine and long-acting injectable antipsychotics as part of a service improvement initiative. Results The prevalence of metabolic syndrome was found to be 60.2% and 49.5% for those on clozapine and long-acting injectable antipsychotics respectively, with no significant difference between groups (χ2 (1, n=198)=2.295, P=0.130). Screening rates were significantly higher for patients receiving clozapine (42.5–96.2%) vs those receiving long-acting injectable antipsychotics (20.5–55.7%). There were significant differences between screening rates and clinical sites; the clozapine clinic had the highest completed screening rate (90.7%). Conclusions Screening of metabolic syndrome is insufficient among patients prescribed long-acting injectable compared to clozapine despite similarly high prevalence. Having a robust screening practice promotes early intervention to prevent metabolic syndrome, reduces the risk of developing comorbid health conditions and premature death, and improves the physical health of patients treated with antipsychotic medications. This study also recommends that service development efforts should target these screening deficiencies to improve the quality of life of patients with severe mental illness.