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Published online by Cambridge University Press: 07 July 2023
To improve Antipsychotic weight monitoring for patients within the Homeless Outreach (START) team.
All adult patients accepted by the START team (Lambeth, Southwark, and Croydon locations) between June and October 2022 that had been initiated on Antipsychotic medication were identified retrospectively (n = 11).
Electronic notes (ePJS) of these patients were subsequently reviewed to assess the following:
1. Was there compliance with NICE weekly weight monitoring (for the first 6 weeks) following Antipsychotic initiation?
2. Was weight measured at least once following Antipsychotic initiation?
3. Was a Physical Health Screen documented following Antipsychotic initiation?
During the audit period a total of 56 patients were accepted by the START team. Of these 11 (20%) were initiated on Antipsychotic medication. 0 patients had weekly weight monitoring compliant with NICE guidelines. 0 patients had their weight measured at least once following Antipsychotic initiation. A Physical Health screen was documented for 4 (36%) patients following Antipsychotic initiation.
This audit highlighted the poor compliance of weight monitoring in this cohort of patients, which can be attributed to several reasons. The homeless population are known to have poor engagement with health services. This coupled with reduced staff awareness of NICE antipsychotic monitoring guidelines can act as a barrier to carrying out appropriate physical health checks.
1. The following interventions were implemented:
2. To address staff awareness, START team members were given a presentation on the importance of Antipsychotic monitoring and current NICE guidelines.
3. An alert will be added to patient notes (ePJS) on initiation of Antipsychotic medication to remind staff to carry out required weight monitoring.
4. Portable weighing scales were purchased for the team to ensure patients’ weight can be measured on outreach reviews.
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.
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