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Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice.
BJPsych Bull. 2016 Oct; 40(5):249-255.BB

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.

Links

Authors+Show Affiliations

Metro North Mental Health, Queensland, Australia; Griffith University, Queensland, Australia.

Metro North Mental Health, Queensland, Australia.

Queensland University of Technology, Queensland, Australia.

Metro North Mental Health, Queensland, Australia.

Metro North Mental Health, Queensland, Australia.

Metro North Mental Health, Queensland, Australia.

Metro North Mental Health, Queensland, Australia.

Metro North Mental Health, Queensland, Australia; The University of Queensland, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27752343

Citation

Patterson, Sue, et al. "Psychiatrists' Follow-up of Identified Metabolic Risk: a Mixed-method Analysis of Outcomes and Influences On Practice." BJPsych Bulletin, vol. 40, no. 5, 2016, pp. 249-255.

Patterson S, Freshwater K, Goulter N, et al. Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice. BJPsych Bull. 2016;40(5):249-255.

Patterson, S., Freshwater, K., Goulter, N., Ewing, J., Leamon, B., Choudhary, A., Moudgil, V., & Emmerson, B. (2016). Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice. BJPsych Bulletin, 40(5), 249-255.

Patterson S, et al. Psychiatrists' Follow-up of Identified Metabolic Risk: a Mixed-method Analysis of Outcomes and Influences On Practice. BJPsych Bull. 2016;40(5):249-255. PubMed PMID: 27752343.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Psychiatrists' follow-up of identified metabolic risk: a mixed-method analysis of outcomes and influences on practice. AU - Patterson,Sue, AU - Freshwater,Kathleen, AU - Goulter,Nicole, AU - Ewing,Julie, AU - Leamon,Boyd, AU - Choudhary,Anand, AU - Moudgil,Vikas, AU - Emmerson,Brett, PY - 2016/10/19/pubmed PY - 2016/10/19/medline PY - 2016/10/19/entrez SP - 249 EP - 255 JF - BJPsych bulletin JO - BJPsych Bull VL - 40 IS - 5 N2 - 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. SN - 2056-4694 UR - https://www.unboundmedicine.com/medline/citation/27752343/Psychiatrists'_follow_up_of_identified_metabolic_risk:_a_mixed_method_analysis_of_outcomes_and_influences_on_practice_ DB - PRIME DP - Unbound Medicine ER -