Screening for and monitoring of cardio-metabolic risk factors in outpatients with severe mental illness in a primary care setting

Abstract

Objective: Recent findings suggest that premature death in patients with severe mental illness (SMI) can be attributed to the high comorbidity of cardio-metabolic disorders. This study investigated the prevalence and monitoring of some risk factors for cardio-metabolic disease in a cohort with SMI, compared to the general medical population. Method: 101 participants with SMI and 100 controls were recruited from a primary care clinic. Assessments of risk factors with standard clinical measurements were done after healthcare workers and patient-participants had completed the structured questionnaires. Clinical files were reviewed to determine frequency of monitoring of risk factors. Results: We found no differences between the groups in demographic variables. A similar prevalence of abnormal blood pressure (BP), increased Body Mass Index (BMI) and increased waist circumference was noted in both groups. Females in both groups were more likely to have an abnormal waist circumference. Patients with SMI were significantly less likely to have recordings of their weight or BP in their clinic file. Healthcare workers and patients with SMI were largely unaware of the increased risk of cardio-metabolic illness. Conclusion: This study suggests that patients with SMI received poorer health monitoring than other patients attending a primary care clinic and that both healthcare workers and patients were poorly informed about the increased risk of cardio-metabolic disorders in patients with SMI.

Key words: Mental illness; Comorbidity; Risk factors; Metabolic; Cardio-vascular