Screening for the metabolic syndrome in Australia: a national survey of psychiatrists' attitudes and reported practice in patients prescribed antipsychotic drugs

Australas Psychiatry. 2016 Feb;24(1):62-6. doi: 10.1177/1039856215618521. Epub 2015 Dec 3.

Abstract

Objective: To investigate current reported psychiatric practice in relation to screening for the metabolic syndrome in patients prescribed antipsychotic drugs within Australia.

Method: A postal survey of all Fellows of the Royal Australian and New Zealand College of Psychiatrists. A 28-item questionnaire inquired into different aspects of screening and monitoring for metabolic syndrome in patients on antipsychotic medication.

Results: Of 3123 questionnaires sent, 955 were returned. Of respondents, 55% had no established metabolic monitoring protocol or guidelines in their work place, with 13% saying they did not know what to monitor to detect metabolic syndrome. Altogether, 76% reported there was no reliable system in place to remind them when to monitor. Fewer than 50% of respondents routinely check weight, fasting glucose or lipids in their patients on antipsychotics and under than 30% checked blood pressure. Waist circumference was routinely checked in fewer than 7% of patients. Basic monitoring equipment was reported unavailable in more than 50% of clinical settings. However, more than 80% of respondents considered monitoring for metabolic syndrome to be their responsibility and 83% felt they had a medicolegal obligation in this respect.

Conclusions: Routine screening for metabolic syndrome in patients on antipsychotic agents, by Australian psychiatrists, is inadequate. Interventions to improve screening rates need to be developed, implemented and evaluated.

Keywords: Australia; metabolic syndrome; psychiatrists; screening.

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Australia
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mass Screening / methods*
  • Mental Disorders / complications*
  • Mental Disorders / drug therapy
  • Metabolic Syndrome / diagnosis*
  • New Zealand
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Psychiatry / statistics & numerical data*
  • Risk Factors
  • Surveys and Questionnaires

Substances

  • Antipsychotic Agents