Cardio-metabolic risk and its management in a cohort of clozapine-treated outpatients

Julia Margaret Lappin; Marlene Wijaya; Andrew Watkins; Rachel Morell; Scott Teasdale; Oscar Lederman; Simon Rosenbaum; Stephanie Dick; Philip Ward; Jackie Curtis

doi:10.1016/j.schres.2018.02.035

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Cardio-metabolic risk and its management in a cohort of clozapine-treated outpatients

Journal article

Peer reviewed

Cardio-metabolic risk and its management in a cohort of clozapine-treated outpatients

Julia Margaret Lappin, Marlene Wijaya, Andrew Watkins, Rachel Morell, Scott Teasdale, Oscar Lederman, Simon Rosenbaum, Stephanie Dick, Philip Ward and Jackie Curtis

Schizophrenia Research, Vol.199, pp.367-373

2018

DOI: https://doi.org/10.1016/j.schres.2018.02.035

PMID: 29486959

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Abstract

Metabolic monitoring

Schizophrenia

Polypharmacy

Treatment

Clozapine

Metabolic syndrome

To comprehensively assess cardio-metabolic risk factors and their management in a large sample of outpatients treated with clozapine. Observational cross-sectional study of all clozapine users attending specialized clozapine monitoring outpatient clinics in three public hospitals in Sydney, Australia were approached to participate over the one-year period 01/10/2015–30/09/2016. Cardio-metabolic risk factors including metabolic syndrome, risk for future development of diabetes, smoking, physical activity, nutrition, and prescribed medications were assessed at face-to-face interview and through medical record review. Among patients who had cardio-metabolic risk factors, the proportion receiving appropriate management was assessed. Of 451 registered clozapine clinic attenders, 92.2% completed questionnaires and anthropometric measurements. 58.3% met criteria for metabolic syndrome. 79.6% were overweight or obese. 55.9% had blood pressure meeting metabolic syndrome criteria. 46.6% had elevated fasting blood glucose and 55.2% had elevated blood triglycerides. 43.6% were current smokers. Only 10% achieved recommended weekly physical activity levels. Unhealthy food categories were highly consumed. 32.1% were on additional antipsychotics. In the majority of individuals, cardio-metabolic risk factors were untreated or under-treated. Clozapine use was associated with very high rates of cardiovascular and metabolic risk factors, which were frequently under-treated. Management of both physical and mental health should be prioritized. Polypharmacy should be rationalized. Future research should investigate the effectiveness of smoking cessation and lifestyle interventions in this high-risk population.

Details

Title: Cardio-metabolic risk and its management in a cohort of clozapine-treated outpatients
Authors: Julia Margaret Lappin (Author) - UNSW Australia
Marlene Wijaya (Author) - UNSW Australia
Andrew Watkins (Author) - New South Wales Health
Rachel Morell (Author) - New South Wales Health
Scott Teasdale (Author) - New South Wales Health
Oscar Lederman (Author) - New South Wales Health
Simon Rosenbaum (Author) - UNSW Australia
Stephanie Dick (Author) - UNSW Australia
Philip Ward (Author) - UNSW Australia
Jackie Curtis (Author) - UNSW Australia
Publication details: Schizophrenia Research, Vol.199, pp.367-373
Publisher: Elsevier B.V
DOI: 10.1016/j.schres.2018.02.035
ISSN: 1573-2509
PMID: 29486959
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99472504202621
Output Type: Journal article

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Web Of Science research areas: Psychiatry

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