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To Assess the Compliance of Monitoring Metabolic Symptoms Associated with Antipsychotics in an Inpatient Setting in a Tertiary Care Hospital in Karachi, Pakistan

Received: 19 October 2019    Accepted: 12 November 2019    Published: 26 November 2019
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Abstract

Mental health problems like schizophrenia, bipolar affective disorder and use of second generation antipsychotics (SGA) are linked to the risk of developing metabolic syndrome. The purpose of our study was to determine the level of compliance to monitoring metabolic symptoms associated with second generation antipsychotics according to the standards of NICE guidelines. Secondly, we aim to develop a workable standardized protocol. A total of 385 patients admitted to psychiatric ward from February 2015-January 2016 were included in the study. Case files were reviewed to obtain relevant clinical information. Assessment of height, weight, pulse, blood pressure, movement disorders, level of physical activity and nutritional status were measured in all patients. Fasting blood glucose was measured in 99 (26.5%), glycosylated hemoglobin (HbA1c) in 39 (10.4%), blood lipid profile in 44 (11.8%) and prolactin in 3 (0.8%) patients. Less than half of the patients (118, 31.6%) underwent ECG investigation. Slow titration of medication (331, 88.5%) and a trial at optimum dosage (343, 81.7%) were routinely seen. Overall physical health and patient well-being was recorded in the majority of subjects (310, 82. 9%). A significant number of physical and biochemical parameters were not routinely monitored. Our study reports findings consistent with previous literature. With this we hope to highlight important concerns and make recommendations, especially in country like Pakistan where these monitoring systems are non-existing. This will not only reduce the risk of a number of complications secondary to antipsychotic medications, but will also improve patient adherence and compliance to the pharmacological treatment.

Published in American Journal of Psychiatry and Neuroscience (Volume 7, Issue 4)
DOI 10.11648/j.ajpn.20190704.16
Page(s) 119-125
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Metabolic Syndrome, Compliance, Antipsychotics

References
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Cite This Article
  • APA Style

    Humera Saeed, Maheen Batool, Muhammad Shameel Khan, Rabeeka Aftab, Mohammad Zaman. (2019). To Assess the Compliance of Monitoring Metabolic Symptoms Associated with Antipsychotics in an Inpatient Setting in a Tertiary Care Hospital in Karachi, Pakistan. American Journal of Psychiatry and Neuroscience, 7(4), 119-125. https://doi.org/10.11648/j.ajpn.20190704.16

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    ACS Style

    Humera Saeed; Maheen Batool; Muhammad Shameel Khan; Rabeeka Aftab; Mohammad Zaman. To Assess the Compliance of Monitoring Metabolic Symptoms Associated with Antipsychotics in an Inpatient Setting in a Tertiary Care Hospital in Karachi, Pakistan. Am. J. Psychiatry Neurosci. 2019, 7(4), 119-125. doi: 10.11648/j.ajpn.20190704.16

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    AMA Style

    Humera Saeed, Maheen Batool, Muhammad Shameel Khan, Rabeeka Aftab, Mohammad Zaman. To Assess the Compliance of Monitoring Metabolic Symptoms Associated with Antipsychotics in an Inpatient Setting in a Tertiary Care Hospital in Karachi, Pakistan. Am J Psychiatry Neurosci. 2019;7(4):119-125. doi: 10.11648/j.ajpn.20190704.16

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  • @article{10.11648/j.ajpn.20190704.16,
      author = {Humera Saeed and Maheen Batool and Muhammad Shameel Khan and Rabeeka Aftab and Mohammad Zaman},
      title = {To Assess the Compliance of Monitoring Metabolic Symptoms Associated with Antipsychotics in an Inpatient Setting in a Tertiary Care Hospital in Karachi, Pakistan},
      journal = {American Journal of Psychiatry and Neuroscience},
      volume = {7},
      number = {4},
      pages = {119-125},
      doi = {10.11648/j.ajpn.20190704.16},
      url = {https://doi.org/10.11648/j.ajpn.20190704.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20190704.16},
      abstract = {Mental health problems like schizophrenia, bipolar affective disorder and use of second generation antipsychotics (SGA) are linked to the risk of developing metabolic syndrome. The purpose of our study was to determine the level of compliance to monitoring metabolic symptoms associated with second generation antipsychotics according to the standards of NICE guidelines. Secondly, we aim to develop a workable standardized protocol. A total of 385 patients admitted to psychiatric ward from February 2015-January 2016 were included in the study. Case files were reviewed to obtain relevant clinical information. Assessment of height, weight, pulse, blood pressure, movement disorders, level of physical activity and nutritional status were measured in all patients. Fasting blood glucose was measured in 99 (26.5%), glycosylated hemoglobin (HbA1c) in 39 (10.4%), blood lipid profile in 44 (11.8%) and prolactin in 3 (0.8%) patients. Less than half of the patients (118, 31.6%) underwent ECG investigation. Slow titration of medication (331, 88.5%) and a trial at optimum dosage (343, 81.7%) were routinely seen. Overall physical health and patient well-being was recorded in the majority of subjects (310, 82. 9%). A significant number of physical and biochemical parameters were not routinely monitored. Our study reports findings consistent with previous literature. With this we hope to highlight important concerns and make recommendations, especially in country like Pakistan where these monitoring systems are non-existing. This will not only reduce the risk of a number of complications secondary to antipsychotic medications, but will also improve patient adherence and compliance to the pharmacological treatment.},
     year = {2019}
    }
    

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    AB  - Mental health problems like schizophrenia, bipolar affective disorder and use of second generation antipsychotics (SGA) are linked to the risk of developing metabolic syndrome. The purpose of our study was to determine the level of compliance to monitoring metabolic symptoms associated with second generation antipsychotics according to the standards of NICE guidelines. Secondly, we aim to develop a workable standardized protocol. A total of 385 patients admitted to psychiatric ward from February 2015-January 2016 were included in the study. Case files were reviewed to obtain relevant clinical information. Assessment of height, weight, pulse, blood pressure, movement disorders, level of physical activity and nutritional status were measured in all patients. Fasting blood glucose was measured in 99 (26.5%), glycosylated hemoglobin (HbA1c) in 39 (10.4%), blood lipid profile in 44 (11.8%) and prolactin in 3 (0.8%) patients. Less than half of the patients (118, 31.6%) underwent ECG investigation. Slow titration of medication (331, 88.5%) and a trial at optimum dosage (343, 81.7%) were routinely seen. Overall physical health and patient well-being was recorded in the majority of subjects (310, 82. 9%). A significant number of physical and biochemical parameters were not routinely monitored. Our study reports findings consistent with previous literature. With this we hope to highlight important concerns and make recommendations, especially in country like Pakistan where these monitoring systems are non-existing. This will not only reduce the risk of a number of complications secondary to antipsychotic medications, but will also improve patient adherence and compliance to the pharmacological treatment.
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Author Information
  • Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan

  • Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan

  • Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan

  • Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan

  • Department of Psychiatry, Aga Khan University Hospital, Karachi, Pakistan

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