Central Coast Local Health District, Central Coast Mental Health, Gosford, New South Wales, Australia.
Int J Ment Health Nurs. 2018 Feb;27(1):303-310. doi: 10.1111/inm.12321. Epub 2017 Feb 24.
The present study is a review of a cardiometabolic clinic for consumers taking clozapine. This clinic was recently established and co-located with the clozapine clinic at a regional hospital in New South Wales, Australia, to enhance engagement and improve the physical health outcomes of consumers taking antipsychotic medication. A descriptive analysis of clients' (n = 73) information collected during routine care for the first 6 months of the clinic's operation, from January 2016 to July 2016, was conducted. First-visit data were analysed to establish a client profile, consisting of weight, height, blood pressure, pulse, a range of blood measurements, smoking status, alcohol consumption, and eating and exercise habits. Data collected for clients who had three or more visits with the general practitioner (n = 40) were analysed separately for outcomes. Two case studies are used to depict the service received and client profile. At the first appointment, the majority of clients had metabolic syndrome that was mostly left untreated; many of these clients were commenced on metformin. The outcomes are positive, and show that the majority of clients lost weight (82.5%) and had a reduction in body mass index (84.6%); nearly half (44.4%) had a reduction in waist circumference. The majority of clients self-reported increased physical activity (72.5%, n = 29) and positive dietary changes (77.5%, n = 31) since their first appointment. The model trialled by the cardiometabolic clinic integrated a specialist mental health and primary care service, and demonstrates success in engaging clients with severe mental illness in physical health care. Co-location is conceptualized as critical for positive patient outcomes and high levels of engagement.
本研究是对一家为服用氯氮平的消费者开设的心脏代谢临床诊所的回顾。该诊所最近在澳大利亚新南威尔士州的一家地区医院内与氯氮平诊所合作成立，旨在提高患者参与度并改善接受抗精神病药物治疗的消费者的身体健康结果。对该诊所运营头 6 个月（2016 年 1 月至 7 月）期间常规护理中收集的 73 名患者的信息进行了描述性分析。通过对初诊数据的分析，建立了患者的基本资料，包括体重、身高、血压、脉搏、一系列血液指标、吸烟状况、饮酒量以及饮食和运动习惯。对与全科医生就诊 3 次或以上的 40 名患者的数据进行了单独分析，以了解其结果。使用两个案例研究来描述所提供的服务和患者的基本情况。在首次就诊时，大多数患者存在代谢综合征，但大部分患者未得到治疗；许多患者开始服用二甲双胍。结果显示，大多数患者体重减轻（82.5%），体重指数（BMI）降低（84.6%），近一半（44.4%）的患者腰围减小。大多数患者自我报告在首次就诊后增加了身体活动（72.5%，n=29），并改变了饮食习惯（77.5%，n=31）。心脏代谢临床诊所尝试的模式整合了专门的心理健康和初级保健服务，证明了它能够成功地让患有严重精神疾病的患者参与到身体健康护理中来。合作定位被认为对患者的积极结果和高参与度至关重要。
