This project team embedded an endocrinology clinic into a mental health outpatient clinic. This led to within a year, much higher rates of clinic attendance and improvement in metabolic markers among attendees.
Mental Health Endocrine Clinic
Initiative Type
Model of Care
Status
Deliver
Added
Last updated
Summary
Key dates
Jul 2017
Implementation sites
Princess Alexandra Hospital
Partnerships
Metro South Addiction and Mental Health Service and the Princess Alexandra Hospital Department of Endocrinology
Aim
This project aims to improve access to tertiary physical health services for people with schizophrenia, leading to improved metabolic health.
Benefits
Improved metabolic health outcomes, and more efficient use of tertiary resources through lower rates of clinic non-attendance.
Background
People with schizophrenia die 18 years earlier than the general population, mostly due to avertable cardiometabolic diseases. Engagement with primary and tertiary health services can be challenging for this population.
Solutions Implemented
By embedding the endocrinologist in an environment familiar and acceptable to people with schizophrenia, the community mental health clinic, failure to attend rates were reduced and metabolic health markers were improved.
Evaluation and Results
Metabolic data were collected retrospectively through electronic records from 48 consecutive patients with schizophrenia, reviewed in the integrated metabolic clinic over a 12 months period. Data from baseline, first follow up and last follow up within 12 months from the initial visit were analysed. Attendance rates at the integrated clinic and those at the general endocrine clinics by a similar mental health patient population were also compared.
Compared with baseline, there was significant improvement in mean ±SEM total cholesterol (5.5±0.3, 5.5±0.3 and 4.9±0.3 mmol/L, p=0.003) and triglyceride (3.0±0.3, 3.1±0.3 and 2.2±0.2 mmol/L, p=0.001). Attendance rate was significantly better in the integrated clinic compared to the that in general endocrine clinics for both initial consult (80.0% versus 51.2%, p<0.001) and review appointment (64.3% vs 47.6%, p<0.001).
Lessons Learnt
Embedding physical health services within a mental health outpatient clinic improves the efficiency of resource usage and leads to improved patient health outcomes.
This project has the potential for replication in other mental health services in Queensland.
