|Contact||Dolly Sud, Consultant Psychiatrist, Leicestershire Partnership NHS Trust|
|Address||Lakeside House, 4 Smith Way, Grove Park, Enderby, Leicester, LE19 1SS|
People who are prescribed anti-psychotic drugs for conditions such as schizophrenia and bipolar disorder are known to be at higher risk of potentially life-limiting conditions associated with obesity, high blood pressure, diabetes and dyslipidaemia (abnormal amounts of cholesterol and/or certain types of fat in the blood).
These risks can be reduced with regular monitoring and early intervention – NICE guidance recommends blood tests and electro-cardiograph (ECG) tests at least annually.
Audits by Prescribing Observatory for Mental Health (POMH-UK) and Leicestershire Partnership NHS Trust found that the physical health of patients taking antipsychotics was only being monitored in a small number of patients. Due to the higher prevalence of side-effects which can impact on physical health this was an important area to address.
A multi-disciplinary team consisting of a Consultant Psychiatrist, Consultant Pathologist and senior pharmacist (Dolly Sud) was formed. This team looked at the issue of physical health in patents taking these medications by first identifying reasons why so few patients were being checked for their physical health. Second to assess what work was currently being done and where there were strengths and weaknesses.
The solution proposed was to develop a centralised electronic database to monitor the physical health of people with antipsychotic drug therapy. The database was designed and backed by the Leicestershire Prescribing Group, Senior Clinical Quality Group and Local Clinical Commissioning groups.
People with mental health issues are allowed to opt-in to the database. They can opt out at any time. Their monitoring can then be done either at a local GP Surgery or Acute trust. People are empowered and can contact the Leicestershire Physical Health Register (LPHR) at any point for hep or information via phone.
Once a patient is referred and registered on the database baseline, three monthly and annual monitoring reminders will be triggered to instigate blood and ECG checks. These are sent to the GP, patient and consultant. The system triggers reminders for patients who don’t have their monitoring done. If results come back indicating an increased risk, their consultant is alerted.
In January 2014 the trust launched a one-year pilot, using the register with mental healthcare professionals across Leicester, Leicestershire and Rutland for people who are newly prescribed anti-psychotic treatment.