Screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics: a quality improvement programme


Thomas R. E. Barnes, Department of Psychological Medicine, Imperial College Faculty of Medicine, Charing Cross Campus, London W6 8RP, UK.


Objective:  The aim was to evaluate a quality improvement programme designed to increase screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics.

Method:  Baseline audit against evidence-based standards, followed by provision of benchmarked data and a range of change interventions, with re-audit 1 year later.

Results:  At baseline, 48 assertive outreach teams across the UK submitted data on screening over the previous year for 1966 patients. At re-audit, 35 of the teams submitted data for 1516 patients. Screening for all four aspects of the metabolic syndrome (measuring blood pressure, obesity, blood glucose and plasma lipids) had increased significantly by re-audit. Clinical variables increasing the likelihood of full screening were clozapine treatment and a known diagnosis of diabetes or dyslipidaemia.

Conclusion:  The programme’s success may be partly attributed to the use of a widely-accepted audit standard, and bespoke change interventions that directly addressed barriers to screening identified by the participating clinical teams.