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Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice

  • Sue Patterson (a1) (a2), Kathleen Freshwater (a1), Nicole Goulter (a3), Julie Ewing (a1), Boyd Leamon (a1), Anand Choudhary (a1), Vikas Moudgil (a1) and Brett Emmerson (a1) (a4)...
Abstract
Aims and method

To describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted.

Results

Metabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a ‘good doctor’ supported comprehensive follow-up.

Clinical implications

Psychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Sue Patterson (susan.patterson@health.qld.gov.au)
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Declaration of interest

All authors are employed by the services within which the research was conducted but the service had no influence on conduct of the study or reporting findings.

Footnotes
References
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Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice

  • Sue Patterson (a1) (a2), Kathleen Freshwater (a1), Nicole Goulter (a3), Julie Ewing (a1), Boyd Leamon (a1), Anand Choudhary (a1), Vikas Moudgil (a1) and Brett Emmerson (a1) (a4)...
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