School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; Clnical Pharmacy Department, Schoolof Pharmacy, Umm Al Qura University, Makkah, KSA.
School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Compr Psychiatry. 2023 Nov;127:152419. doi: 10.1016/j.comppsych.2023.152419. Epub 2023 Sep 9.
This study aimed to investigate the level of guideline adherence for cardiometabolic health monitoring for patients prescribed antipsychotic medicines in UK primary care.
In this population-based retrospective open cohort study, we used dataset of patients from the IQVIA Medical Research Data (IMRD) database between 1st January 2003 to 31st December 2018. Clinical Read codes were used to identify a cohort of adult patients with a diagnosis of Schizophrenia and at least four prescriptions of an anti-psychotic medication within 12 months of diagnosis. We then extracted data in relation to monitoring of cardiometabolic parameters (body compositions, lipids, and glucose outcomes) at baseline, then at six weeks, 12 weeks, and then 12 months. The frequency of outcome monitoring was described using descriptive statistics.
A total of 11,435 patients were eligible and of them (n = 9707; 84·8%) were prescribed second-generation antipsychotics (SGAs). Only a small portion of the cohort (≈2·0%) received complete monitoring (at time points) for certain outcomes. Just over half the patients (n = 6599, 52%) had evidence of any cardiometabolic baseline testing for any of the study outcomes and the high majority had at least one abnormal lab value at baseline (n = 4627, 96·7%).
In UK primary care, cardiometabolic monitoring practices among patients prescribed antipsychotics remain suboptimal. There is a need to promote guideline adherence to prevent adverse outcomes in antipsychotic users.
本研究旨在调查英国初级保健中开具抗精神病药物的患者进行心脏代谢健康监测的指南遵循水平。
在这项基于人群的回顾性开放队列研究中，我们使用了 IQVIA Medical Research Data（IMRD）数据库中 2003 年 1 月 1 日至 2018 年 12 月 31 日期间的患者数据集。临床读取代码用于识别一组成年患者，这些患者被诊断为精神分裂症，并且在诊断后的 12 个月内至少有四种抗精神病药物的处方。然后，我们提取了与心脏代谢参数（身体成分、血脂和血糖结果）基线、6 周、12 周和 12 个月监测相关的数据。使用描述性统计描述了结果监测的频率。
共有 11435 名患者符合条件，其中 9707 名（84.8%）患者被开了第二代抗精神病药物（SGAs）。只有一小部分患者（≈2.0%）接受了某些结果的完整监测（在时间点）。超过一半的患者（n=6599，52%）有任何研究结果的任何心脏代谢基线测试的证据，绝大多数患者在基线时有至少一个异常的实验室值（n=4627，96.7%）。
在英国初级保健中，开具抗精神病药物的患者的心脏代谢监测实践仍不理想。需要促进指南的遵守，以防止抗精神病药物使用者出现不良后果。
