People who receive antipsychotic therapy may experience side effects which negatively impact on their physical health, for example weight gain, leading to other associated health issues such as heart disease and diabetes.
Dolly Sud, a pharmacist in the Leicestershire Partnership NHS Foundation Trust, identified the need to improve physical health monitoring.
“As a pharmacist, I see the disparity between the treatment of people with mental and physical health problems, including issues faced by patients taking antipsychotic drugs. Audits carried out by the Leicestershire Partnership NHS Trust and the Prescribing Observatory for Mental Health (POMH-UK), show a low rate of physical health monitoring for people on antipsychotic drug therapy. This needed to change”
Dolly Sud worked with a range of professionals in primary and secondary care in Leicester.
A centralised electronic database known as the Leicestershire Physical Health Register (LPHR) was developed, trialled and sustained. The service user is referred by the prescriber to the LPHR regardless of the healthcare setting. The service user receives an information leaflet about the register. Once registered, welcome letters are sent and monitoring physical health begins. Service user choose where they wish to be seen e.g. GP surgery or local hospital. Using the screening results, pharmacists can make appropriate interventions. This includes informing other clinicians of abnormal results and suitable interventions based on the LESTER tool.
There are plans to measure the long term impact of interventions.
The Trust achieved a 97% rate on the national physical health CQUIN in 2014/2015 – the highest rate of any Trust in England.
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The work developed over several years - making and sustaining changes takes time
Be optimistic!
Develop a good understanding of the health care model in operation
Service users may be receptive to intervention at some point in their journey, despite not having a good history of engaging.
