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  • Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice

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    Author(s)
    Patterson, Sue
    Freshwater, Kathleen
    Goulter, Nicole
    Ewing, Julie
    Leamon, Boyd
    Choudhary, Anand
    Moudgil, Vikas
    Emmerson, Brett
    Griffith University Author(s)
    Patterson, Susan
    Year published
    2016
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    Abstract
    Aims and method: To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results: Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills ...
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    Aims and method: To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted. Results: Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a ‘good doctor’ supported comprehensive follow-up. Clinical implications: Psychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.
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    Journal Title
    BJ Psych Bulletin
    Volume
    40
    Issue
    5
    DOI
    https://doi.org/10.1192/pb.bp.114.049379
    Copyright Statement
    This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Subject
    Clinical sciences not elsewhere classified
    Publication URI
    http://hdl.handle.net/10072/124077
    Collection
    • Journal articles

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