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Audit on Physical Health Monitoring Baseline Checks for Patients accepted by Adolescent Bipolar Service (ABS)

Lookup NU author(s): Francis Bennett-Henman, Dr Aditya SharmaORCiD


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Background Mental health service users have higher levels of physical co-morbidities than the general population [1], often due to the metabolic effects of psychotropic medication. Therefore, physical health monitoring is important in assessing these side effects. Aims To audit clinical practice according to the current local and national standard [2], requiring 100% completion of: Blood tests (FBC, LFT’s, thyroid function, renal function, serum prolactin, blood glucose and lipid profile) ECG Physical observations (height, weight, BP, pulse) Methodology Retrospective study of all patients accepted by ABS between 01/07/2009-31/12/2013, reviewing electronic records using a structured pro-forma. Results Referred patients (n=47) were only included in the study if the referral was accepted by ABS (n=28). ABS performed well on blood tests and ECG’s, with 82.1% of patients having blood test results. ECG results also encouraging, with a completion rate of 71.4%. The service did not perform as well when carrying out the physical observations, completing only 7.1% of these. Conclusions The main reasons identified for the service’s performance on physical observations included a lack of electronic or paper reminders and a shortage of medically trained staff to carry out observations. ABS has already started to address the latter by employing a nurse to facilitate in this process. The main recommendation from this audit is the design of a paper pro-forma to be completed at initial consultations. This should maintain relatively good practice in completion of bloods/ECG’s and improve physical health checks. References Angst, F., Stassen, H.H., Clayton, P.J. and Angst, J. (2002) 'Mortality of patients with mood disorders: follow-up over 34–38 years', Journal of Affective Disorders, 68(2–3), pp. 167-181. National Institute for Health and Clinical Excellence (2006) The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care. London: NICE.

Publication metadata

Author(s): Bennett-Henman F, LeCouteur A, Willis C, Sharma A

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Faculty of Child & Adolescent Psychiatry Annual Conference 2014

Year of Conference: 2014