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Monitoring and Management of Cardiometabolic Risk Factors in Schizophrenia- A Global Perspective: Rationale, Aims and Methods
Current Issue
Volume 2, 2014
Issue 1 (February)
Pages: 24-32   |   Vol. 2, No. 1, February 2014   |   Follow on         
Paper in PDF Downloads: 17   Since Aug. 28, 2015 Views: 2173   Since Aug. 28, 2015
Uwakwe Richard, Faculty of Medicine, Nnamdi-Azikiwe University, Nnewi Campus, Anambra, Nigeria.
Ramachandran Padmavati, Schizophrenia Research Foundation, Chennai,Tamilnadu, India.
De Hert Marc, Departement of Neuroscience, University Psychiatric Centre, KU Leuven, Belgium.
Hasnain Mehrul, Department of Psychiatry, Fatima Memorial Hospital, Shadman, Lahore Pakistan.
Vancampfort Davy, Departement of Neuroscience, University Psychiatric Centre, KU Leuven, Belgium.
Omoaregba Joyce, mergency & Assessment Unit, Dept. of Clinical Services, Federal Neuro-Psychiatric Hospital, BeninCity, Nigeria.
Mohammed Jidda, Research and Training Dept. Federal Neuro-Psychiatric Hospital, Maiduguri, Nigeria.
Hjorth Peter, Psychiatric Research Unit, Aalborg Psychiatric Hospital, Denmark.
Modebe Ifeoma, Faculty of Medicine, Nnamdi-Azikiwe University, Nnewi Campus, Anambra, Nigeria.
Haider Imran, Department of Psychiatry, Fatima Memorial Hospital, Shadman, Lahore Pakistan.
Ogualili Placidus, Faculty of Medicine, Nnamdi-Azikiwe University, Nnewi Campus, Anambra, Nigeria.
Haddad Peter, Neuroscience and Psychiatry Unit, University of Manchester, United Kingdom..
Jorgensen Povl, Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark.
Kilian Reinhold, Universität Ulm Klinik für Psychiatrie und Psychotherapie II Sektion: Gesundheitsökonomie und Versorgungsforschung, Ludwig Heilmeyer-Str. Günzburg Deutschland.
Becker Thomas, Universität Ulm Klinik für Psychiatrie und Psychotherapie II Sektion: Gesundheitsökonomie und Versorgungsforschung, Ludwig Heilmeyer-Str. Günzburg Deutschland.
Blankehorn Dorothea, Universität Ulm Klinik für Psychiatrie und Psychotherapie II Sektion: Gesundheitsökonomie und Versorgungsforschung, Ludwig Heilmeyer-Str. Günzburg Deutschland.
Background: The excess morbidity and mortality associated with schizophrenia is partly due to cardiovascular diseases resulting from the complex inter-relationships between unhealthy life style including, metabolic problems, and the metabolic risks associated with the use of psychotropic medications. The current project involves patients with schizophrenia, their informal care providers and the health professionals, who treat them. Aims; Our primary aim in the Monitoring and Management of Cardiovascular Risk factors In Schizophrenia (MOMACRIS) Project is to determine whether an integrated mental and physical health care approach that involves patients with schizophrenia, their informal care providers and the health professionals who treat them, would improve identification, management and outcome of cardio-metabolic risk factors in these patients. Methods; We assess the knowledge and attitude of patients, their informal care providers and health care professionals about general cardiometabolic risk factors and life style modification. We also assess the current cardiometabolic monitoring and management practices by the health care professionals who treat patients with schizophrenia and we identify any barriers that may be limiting what theses care professionals do. At baseline we assess the needs for improved cardiometbolic monitoring. Thereafter we carry on culturally-tailored psycho-educational based interventions directed at the patients with schizophrenia, their informal care providers and health care professionals following the baseline assessments of the identified needs for improved cardiometbolic monitoring. This will be achieved in an integrated collaborative effort between psychiatrists, psychologists, general/family physicians (or internists/endocrinologists), dieticians and physiotherapists. Conclusion; Morbidity and mortality from cardiometabolic risk in schizophrenia is higher than chance occurrence. Identification and management of these risk factors seem to be hampered by a number of barriers despite years of developing one guide line after another. There is need to re-evaluate the current knowledge, beliefs and practice of everyone concerned with schizophrenia.
Schizophrenia, Cardiometabolic, Risk Factors, Monitoring, Management
Allison DB, Newcomer JW, Dunn AL, Blumenthal JA, Fabricatore AN, Daumit GL, et al. Obesity among those with mental disorders: a National Institute of Mental Health meeting report. Am J Prev Med 2009 Apr;36(4):341-50.
American Diabetes Association. Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004 Feb;27(2):596-601.
Barnes TR, Paton C, Cavanagh MR, Hancock E, Taylor DM. A UK audit of screening for the metabolic side effects of antipsychotics in community patients. Schizophr Bull 2007 Nov;33(6):1397-403.
Beary M,Wildgust HJ. A critical review of major mortality risk factors for all-cause mortality in first-episode schizophrenia: clinical and research implications. Journal of Psychopharmacol. 2012; 26(5 Suppl):52-61
Bocquier A, Verger P, Basdevant A, Andreotti G, Baretge J, Villani P, et al. Overweight and obesity: knowledge, attitudes, and practices of general practitioners in france. Obes Res 2005 Apr;13(4):787-95.
Correll CU. Balancing efficacy and safety in treatment with antipsychotics. CNS Spectr 2007 ;12(10 Suppl 17):12-20, 35.
De Hert M, Vancampfort D, Correll CU, Mercken V, Peuskens J, Sweers K, Mitchell AJ. Guidelines for screening and monitoring of cardiometabolic risk in schizophrenia: systematic evaluation. Br J Psychiatry 2011; 199(2): 99-105
De HM, Dekker JM, Wood D, Kahl KG, Holt RI, Moller HJ. Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). Eur Psychiatry 2009 Sep;24(6):412-2
De NA, De HM, Scheen A, Van GL, Peuskens J. [Conference report: Belgian consensus on metabolic problems associated with atypical antipsychotics]. Encephale 2007 Mar;33(2):197-202.
Deurenberg-Yap M, Li T, Tan WL, van Staveren WA, Chew SK, Deurenberg P. Can dietary factors explain differences in serum cholesterol profiles among different ethnic groups (Chinese, Malays and Indians) in Singapore? Asia Pac J Clin Nutr 2001;10(1):39-45.
Expert Group. 'Schizophrenia and Diabetes 2003' Expert Consensus Meeting, Dublin, 3-4 October 2003: consensus summary. Br J Psychiatry Suppl 2004 Apr;47:S112-S114.
Faulkner, G., Cohn, T., Remington, G., 2006.Validation of a physical activity assessment tool for individuals with schizophrenia.Schizophr. Res. 82, 225–231.
Glover, G., et al. (1997). The development of a new minimum data set for specialist mental health care, Health Trends, 29: 48-51.
Gough SC, O'donovan MC. Clustering of metabolic comorbidity in schizophrenia: a genetic contribution? J Psychopharmacol 2005 Nov;19(6 Suppl):47-55.
Hasnain M, Vieweg WV, Fredrickson SK, Beatty-Brooks M, Fernandez A, Pandurangi AK. Clinical monitoring and management of the metabolic syndrome in patients receiving atypical antipsychotic medications. Prim Care Diabetes 2009 Feb;3(1):5-15.
Hennekens CH, Hennekens AR, Hollar D, Casey DE. Schizophrenia and increased risks of cardiovascular disease. Am Heart J 2005 Dec;150(6):1115-21.
Hippisley-Cox J, Parker C, Coupland C, Vinogradova Y. Inequalities in the primary care of patients with coronary heart disease and serious mental health problems: a cross-sectional study. Heart 2007 Oct;93(10):1256-62.
Jacobs R. Investigating Patient Outcome Measures in Mental Health. Centre for Health Economics, University of York, York, 2009.
Koola MM, McMahon RP, Wehring HJ, Liu F, Mackowick KM, Warren KR, Feldman S,Shim JC, Love RC, Kelly DL. Alcohol and cannabis use and mortality in people with schizophrenia and related psychotic disorders. J Psychiatr Res. 2012; 46(8):987-93
Lambert TJ, Newcomer JW. Are the cardiometabolic complications of schizophrenia still neglected? Barriers to care. Med J Aust 2009 Feb 16;190(4 Suppl):S39-S42.
Lambert TJ, Chapman LH. Diabetes, psychotic disorders and antipsychotic therapy: a consensus statement. Med J Aust 2004 Nov 15;181(10):544-8.
Larsen JI, Andersen UA , Becker T , Bickel GG, Bernhard Bork, Cordes J, Frasch K , Jacobsen BA,Jensen SOW, Reinhold Kilian, Lauber C,, Mogensen B N, Nielsen JA, Rossler W, Tsuchiya KJ, Uwakwe R, Munk-Jorgensen P . Cultural diversity in physical diseases among patients with mental illnesses.Australian and New Zealand Journal of Psychiatry 2013, 47: 250-258.
Leucht S, Burkard T, Henderson J, et al (2007) Physical illness and
Schizophrenia: A review of the literature. ActaPsychiatricaScandinavica 2007, 116: 317 – 333.
Mackin P, Bishop DR, Watkinson HM. A prospective study of monitoring practices for metabolic disease in antipsychotic-treated community psychiatric patients. BMC Psychiatry 2007;7:28.
Mackin P, Bishop DR, Watkinson HM. A prospective study of monitoring practices for metabolic disease in anti psychotic treated community psychiatric patients.BMC Psychiatry 2007, 7: 28.
Merz CN, Buse JB, Tuncer D, Twillman GB. Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes. J Am Coll Cardiol 2002 Nov 20;40(10):1877-81.
Mitchell AJ, Delaffon V, Vancampfort D, Correll CU, De Hert M. Guideline concordant monitoring of metabolic risk in people treated with antipsychotic medication: systematic review and meta-analysis of screening practices. Psychol Med 2012; 42(1): 125-147.
Nasrallah HA, Meyer JM, Goff DC, McEvoy JP, Davis SM, Stroup TS, et al. Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: data from the CATIE schizophrenia trial sample at baseline. Schizophr Res 2006 Sep;86(1-3):15-22.
Ohaeri JU, Akanji AO. Metabolic Syndrome in Severe Mental Disorders. Metab Syndr Relat Disord 2010 Oct 21.
Osler M, Heitmann BL, Hoidrup S, Jorgensen LM, Schroll M. Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study. J Epidemiol Community Health 2001 Jun;55(6):399-403.
Peet M. Diet, diabetes and schizophrenia: review and hypothesis. Br J Psychiatry Suppl 2004 Apr;47:S102-S105.
Pirkis JE, Burgess PM, Kirk PK, Dodson S, Coombs TJ, Williamson MK. A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures. Health Qual Life Outcomes 2005;3:76.
Puig RA, McKenna J, Riddoch C. Attitudes and practices of physicians and nurses regarding physical activity promotion in the Catalan primary health-care system. Eur J Public Health 2005 Dec;15(6):569-75.
Ralph Maddison R,Mhurch CN, Jiang Y, Vander Hoorn S, Rodgers A, Lawes CMM, Rush E. International Physical Activity Questionnaire (IPAQ) and New Zealand Physical Activity Questionnaire (NZPAQ): A doubly labelled water validation. International Journal of Behavioural Nutrition nd Physical activity, 2007, 4: 52.
Roick C, Fritz-Wieacker A, Matschinger H, Heider D, Schindler J, Riedel-Heller S, et al. Health habits of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2007 Apr;42(4):268-76.
Roberts L, Roalfe A, Wilson S, Lester H. Physical health care of patients with schizophrenia in primary care: a comparative study. Fam Pract 2007 Feb;24(1):34-40.Saha S, Chant D, McGrath J. A systematic Review of Mortality in
schizophrenia. Is the Differential Mortality Gap worsening over time?Archives of General Psychiatry 2007, 64 (10): 1123 – 1131
Spearing MK, Post RM, Leverich GS, Brandt D, Nolen W. Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 1997 Dec 5;73(3):159-71.
Tiihonen J, Lonnqvist J, Wahlbeck K, Klaukka T, Niskanen L, Tanskanen A, et al. 11-year follow-up of mortality in patients with schizophrenia: a population-based cohort study (FIN11 study). Lancet 2009 Aug 22;374(9690):620-7.
Vancampfort D, Knapen J, Probst M et al. Considering a frame of reference for physical activity research related to the cardiometabolic risk profile in schizophrenia. Psychiatry Res 2010; 177: 271-279.
Wildgust HJ, Beary M. Are there modifiable risk factors which will reduce the excess mortality in schizophrenia? J Psychopharmacol. 2010;24(4 Suppl):37-50
Zibaeenezhad MJ BHVS. Knowledge, attitude and practice of general physicians in treatment and complications of hypertension in Fars province, southern Iran. Iraninan Red Crescent Medical Journal 2007;9:4-8.
Hayes RJ, Benneth S. Simple sample size calculation for cluster randomized trials. International Journal of Epidemiology 1999, 28: 319-326.
Morrato EH, Newcomer JW, Kamat S, Baser O, Harnet J, Cuffel B. Metabolic screening after the American Diabetic Association‘s consensus statement on antipsychotic drugs and diabetes . Diabetes Care 2009, 32: 1037-1042.
Albert KG, Zimmer PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part I. Diagnosis and classification of diabetes mellitus – provisional report of a WHO consultation. Diabetes Medicine 1998, 15: 539-553.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001, 285: 2486–2497.
Bobes J, Alegria AA, Saiz-Gonzalez MD, Barber I, Perez JL, Saiz-Ruiz J. Change in psychiatrist ’attitudes towards the physical health care of patients with schizophrenia coinciding with the dissemination of the consensus on physical health in patients with schizophrenia. European Psychiatry 2010, doi:10.1016/j.eurpsy.2010.04.004
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