Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 4;20(1):581.
doi: 10.1186/s12888-020-02990-6.

Barriers to monitoring and management of cardiovascular and metabolic health of patients prescribed antipsychotic drugs: a systematic review

Ruba Azfr Ali  1   2 , Zahraa Jalal  1 , Vibhu Paudyal  3
Affiliations

Barriers to monitoring and management of cardiovascular and metabolic health of patients prescribed antipsychotic drugs: a systematic review

Ruba Azfr Ali et al. BMC Psychiatry. .

Abstract

Background: The use of atypical antipsychotics which currently form the primary choice pharmacotherapy for several mental health conditions have been linked to cardiovascular and metabolic side effects. This systematic review aimed to investigate the barriers to monitoring and management of cardiovascular co-morbidities in patients prescribed antipsychotic medicines.

Methods: A protocol-led (CRD-42018106002) systematic literature review was conducted by searching Medline, Embase, and PsycINFO databases 2003 until October 2019. Cochrane, Centre for Review and Dissemination (CRD) and PRISMA guidelines were followed. Studies investigating barriers to monitoring and management of cardiovascular co-morbidities in patients prescribed antipsychotic medicines were included.

Results: A total of 23 records were included. Key barriers included a) health-care system-related factors such as lack of knowledge and expertise amongst care providers, available resources, confusion around remit and roles, fragmentation of care such as across general practitioners and psychiatrists, and time constraints and b) patient-related factors such as disability resulting from mental health conditions, knowledge and skills of the patients.

Conclusion: Barriers to monitoring and management of cardiovascular and metabolic health of patients taking antipsychotic medicines are multidimensional. Apart from educational interventions directed to both patients and health-care professionals, the results suggest a need for the improvement of wider system-related factors to improve physical health of patients prescribed antipsychotic medicines. Clearer guidelines, clarity of remit and roles amongst service providers are necessary in addition to educational interventions directed at patients and health-care professionals in improving physical health monitoring, counselling and management of patients prescribed antipsychotic medicines.

Trial registration: A protocol was developed and registered with PROSPERO as per PRISMA-P guidelines ( CRD 42018106002 ).

Keywords: Antipsychotics; Comorbidity; Drug interactions and side effects; Patient Counselling research; Primary care.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of the selection process
See this image and copyright information in PMC

References

    1. Vancampfort D, Wampers M, Mitchell AJ, Correll CU, De Herdt A, Probst M, et al. A meta-analysis of cardio-metabolic abnormalities in drug naïve, first-episode and multi-episode patients with schizophrenia versus general population controls. World Psychiatry. 2013;12:240–250. doi: 10.1002/wps.20069. - DOI - PMC - PubMed
    1. Westman J, Eriksson SV, Gissler M, Hällgren J, Prieto ML, Bobo WV, Frye MA, Erlinge D, Alfredsson L, Ösby U. Increased cardiovascular mortality in people with schizophrenia: a 24-year national register study. Epidemiol Psychiatr Sc. 2018;27:519–527. doi: 10.1017/S2045796017000166. - DOI - PMC - PubMed
    1. Mitchell AJ, Vancampfort D, De Herdt A, Yu W, De Hert M. Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? A comparative meta-analysis of first episode, untreated and treated patients. Schizophr Bull. 2013:295–305. - PMC - PubMed
    1. Morrato EH, Druss B, Hartung DM, Valuck RJ, Allen R, Campagna E, et al. Metabolic testing rates in 3 state Medicaid programs after FDA warnings and ADA/APA recommendations for second-generation antipsychotic drugs. Arch Gen Psychiatry. 2010;67:17–24. doi: 10.1001/archgenpsychiatry.2009.179. - DOI - PubMed
    1. Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes. Obes Res. 2004;27:362–8. - PubMed

Publication types

Substances

LinkOut - more resources