Outcomes of an integrated approach for metabolic healthcare for people with schizophrenia

Abstract

Background: Metabolic syndrome is highly prevalent among people with schizophrenia. It is often underdiagnosed and undertreated. Significant gaps in appropriate testing for metabolic syndrome among people with schizophrenia and the provision of evidence-based treatments where metabolic syndrome is detected have been identified with challenges in integrating specialist metabolic and psychiatric services.

Objectives: The aim of this study is to assess the impact on metabolic health outcomes for people with schizophrenia by an integrated metabolic clinic embedded within a community mental health service.

Methods: Metabolic data were collected retrospectively through electronic records from 48 consecutive patients with schizophrenia reviewed in the integrated metabolic clinic over a 12-month period. Data from baseline, first follow-up and last follow-up within 12 months from the initial visit were analysed. Attendance rates between the integrated clinic and those at the general endocrine clinics of similar mental health patient populations were also compared.

Findings: Average weight, body mass index, waist circumference, blood pressure and glycated haemoglobin did not change significantly. Compared with baseline, there was significant improvement in mean ± standard error of the mean in total cholesterol (5.54 ± 0.32, 5.47 ± 0.26 and 4.93 ± 0.27 mmol/L, p = 0.003) and triglyceride (2.95 ± 0.26, 3.11 ± 0.29 and 2.20 ± 0.18 mmol/L, p = 0.001). Attendance rate was significantly better in the integrated clinic compared to that in general endocrine clinics for both initial consult (80.0% versus (vs.) 51.2%, p < 0.001) and review appointment (64.3% vs. 47.6%, p < 0.001).

Conclusions: The integration of a specialist metabolic clinic within a mental health service resulted in better patient engagement and improvements in metabolic health in people with schizophrenia.