Scientific Reports (May 2024)

Transmural collaborative care model for the review of antipsychotics: a feasibility study of a complex intervention

  • Kirsti M. Jakobs,
  • Karlijn J. van den Brule-Barnhoorn,
  • Jan van Lieshout,
  • Joost G. E. Janzing,
  • Wiepke Cahn,
  • Maria van den Muijsenbergh,
  • Marion C. J. Biermans,
  • Erik W. M. A. Bischoff

DOI
https://doi.org/10.1038/s41598-024-62349-9
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 10

Abstract

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Abstract General practitioners (GPs) are often unaware of antipsychotic (AP)-induced cardiovascular risk (CVR) and therefore patients using atypical APs are not systematically monitored. We evaluated the feasibility of a complex intervention designed to review the use of APs and advise on CVR-lowering strategies in a transmural collaboration. A mixed methods prospective cohort study in three general practices in the Netherlands was conducted in 2021. The intervention comprised three steps: a digital information meeting, a multidisciplinary meeting, and a shared decision-making visit to the GP. We assessed patient recruitment and retention rates, advice given and adopted, and CVR with QRISK3 score and mental state with MHI-5 at baseline and three months post-intervention. GPs invited 57 of 146 eligible patients (39%), of whom 28 (19%) participated. The intervention was completed by 23 (82%) and follow-up by 18 participants (64%). At the multidisciplinary meeting, 22 (78%) patients were advised to change AP use. Other advice concerned medication (other than APs), lifestyle, monitoring, and psychotherapy. At 3-months post-intervention, 41% (28/68) of this advice was adopted. Our findings suggest that this complex intervention is feasible for evaluating health improvement in patients using AP in a trial.