Cardiometabolic screening for people using Clozapine
The average life expectancy of a person with enduring mental illness is up to 25 years less than those without mental illness.
Knowing that psychiatric medication is a key contributor to poorer health outcomes, a team in Nelson Marlborough began investigating what was going on for tāngata whaiora (people seeking wellness) using Clozapine. Clozapine is an effective drug to treat schizophrenia but is known to have some nasty side effects, especially to cardiometabolic function.
Despite the risks, the team found that only two per cent of people prescribed Clozapine were regularly screened for cardiometabolic issues.
Jen Hassloch, Nelson Marlborough Health Improvement Advisor and project team member, says tāngata whaiora and their whānau expressed concerns when asked about their experience with Clozapine.
“They were concerned about weight gain, they didn’t always trust the healthcare services, there were health literacy challenges, experience of poor coordination between services, and we found there were financial barriers for some,” Jen says.
These findings prompted action. A registered nurse was appointed to arrange cardiometabolic screening for people with Clozapine prescriptions.
Now, when tāngata whaiora attend their specialist appointments, they may also be referred for electrocardiogram tests, blood tests and for follow-up appointments with their GP as part of the cardiometabolic screening programme. Health education and assistance with prescription side effects is also offered.
Since screening started early in 2018, 91 per cent of people prescribed Clozapine in Nelson Marlborough have been screened. Most have also had other support to help improve their health and quality of life.
Jen says that this success is particularly due to having one person managing the screening process and building trust and rapport along the way.
“Now it’s standard practice for anyone starting on Clozapine to have cardiometabolic screening. This captures a baseline of valuable health information so that we can consider what might be needed if someone’s metabolic function changes while they are taking Clozapine,” Jen says.
“The aim is to make life easier for people on this medication and to improve their overall health and wellbeing while they are engaged with mental health services.”
The Cardiometabolic screening for people using Clozapine: an Equally Well initiative project won the Darcy Christopher overall excellence award in the 2020 Health Innovation Awards.