A narrative review of metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness

Abstract

Introduction: Patients with severe mental illness (SMI) have poor physical wellbeing, leading essentially shorter lives, compared with the general population. Routine metabolic monitoring is proposed as a strategy for recognizing risk factors for metabolic variations in this population. This narrative review aimed to identify interventions at enhancing uptake of metabolic monitoring parameters in adult prescribed second generation antipsychotics (SGAs) for patients with SMI. Method: A literature search was performed through SCOPUS, PubMed, and CINAHL databases using a combination of keywords. We included primary studies published in the English language until December 2021 that provided evidence on interventions to increase the rate of SGAs related metabolic monitoring in patients with SMI. Results: A total of 21 studies were identified among which in 13 studies frequency of metabolic monitoring ranged between 40% and 80% after implementation of various strategies. These include multi-layer intervention model such as: (A) Reminders (e.g., paper-based prompts, invitation letter); (B) Electronic system of documentation (computer-based intervention, electronic medical records); (C) Healthcare practitioner specific role (Nurse-led intervention, pharmacist-led intervention, barrier focused strategies) and (D) Physical-mental health awareness (Education, quality improvement programme). Conclusion: This review provides evidence that studies involving the reminders such as paper based prompts and education to the patients as well as healthcare professionals could help in enhancing the rate of metabolic monitoring in patients prescribed SGAs.

Keywords

• Early interventions
• Metabolic syndrome
• Cardiovascular disease
• Mental health
• Second generation antipsychotics