Cardiovascular and Metabolic Risk Management in an Adult Population with Schizophrenia: A Quality Improvement Project
Abstract
ABSTRACT
Background: Individuals with schizophrenia are at higher risk of experiencing significant co-occurring medical conditions including cardiovascular disease and metabolic syndrome, which highlights a priority for strategies to improve CV risks and health outcomes.Purpose: The purpose of this quality improvement project was to reduce cardiometabolic risk factors of an adult population with schizophrenia through an integrative approach, additionally exploring the perceptions related to the barriers to healthcare engagement.Methods: Individuals presenting to an outpatient injection clinic over a one week period were invited to participate in cardiometabolic screening and associated risks, and completion of a self-report questionnaire regarding the barriers to access. Interventions included obtaining the recommended metabolic screening, initiating healthy lifestyle education, initiation of statin therapy, if indicated, and appropriate referrals for abnormal HgbA1c levels. At four weeks participants were asked to return to evaluate efficacy of interventions.Finding/Results: Ninety percent of the participants did not have the recommended metabolic screening. Use of the recommended CVD risk calculator did not indicate the need for initiating statin therapy. Participants had significant engagement in education demonstrating a desire for healthy lifestyle changes. Forty percent of smokers expressed the desire to quit smoking. Limitations included the small sample size and restricted participant recruitment time period.Implications: This project identified the value of an integrative approach to improving health outcomes and the need for process improvement regarding metabolic screening as well as contributing perceptions of personal barriers to access.Keywords: integrated care, schizophrenia, access, barriers, metabolic, cardiovascular
Background: Individuals with schizophrenia are at higher risk of experiencing significant co-occurring medical conditions including cardiovascular disease and metabolic syndrome, which highlights a priority for strategies to improve CV risks and health outcomes.Purpose: The purpose of this quality improvement project was to reduce cardiometabolic risk factors of an adult population with schizophrenia through an integrative approach, additionally exploring the perceptions related to the barriers to healthcare engagement.Methods: Individuals presenting to an outpatient injection clinic over a one week period were invited to participate in cardiometabolic screening and associated risks, and completion of a self-report questionnaire regarding the barriers to access. Interventions included obtaining the recommended metabolic screening, initiating healthy lifestyle education, initiation of statin therapy, if indicated, and appropriate referrals for abnormal HgbA1c levels. At four weeks participants were asked to return to evaluate efficacy of interventions.Finding/Results: Ninety percent of the participants did not have the recommended metabolic screening. Use of the recommended CVD risk calculator did not indicate the need for initiating statin therapy. Participants had significant engagement in education demonstrating a desire for healthy lifestyle changes. Forty percent of smokers expressed the desire to quit smoking. Limitations included the small sample size and restricted participant recruitment time period.Implications: This project identified the value of an integrative approach to improving health outcomes and the need for process improvement regarding metabolic screening as well as contributing perceptions of personal barriers to access.Keywords: integrated care, schizophrenia, access, barriers, metabolic, cardiovascular