Screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics: a quality improvement programme

Acta Psychiatr Scand. 2008 Jul;118(1):26-33. doi: 10.1111/j.1600-0447.2008.01203.x.


Objective: The aim was to evaluate a quality improvement programme designed to increase screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics.

Method: Baseline audit against evidence-based standards, followed by provision of benchmarked data and a range of change interventions, with re-audit 1 year later.

Results: At baseline, 48 assertive outreach teams across the UK submitted data on screening over the previous year for 1966 patients. At re-audit, 35 of the teams submitted data for 1516 patients. Screening for all four aspects of the metabolic syndrome (measuring blood pressure, obesity, blood glucose and plasma lipids) had increased significantly by re-audit. Clinical variables increasing the likelihood of full screening were clozapine treatment and a known diagnosis of diabetes or dyslipidaemia.

Conclusion: The programme's success may be partly attributed to the use of a widely-accepted audit standard, and bespoke change interventions that directly addressed barriers to screening identified by the participating clinical teams.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Benchmarking / standards
  • Body Weight / drug effects
  • Community Mental Health Services / standards
  • Community-Institutional Relations / standards
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • England
  • Female
  • Health Services Accessibility
  • Humans
  • Life Style
  • Male
  • Mass Screening / standards*
  • Medical Audit / standards
  • Metabolic Syndrome / chemically induced*
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Mood Disorders / drug therapy*
  • Mood Disorders / epidemiology
  • Physical Examination
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Quality Assurance, Health Care / standards*
  • Quality Indicators, Health Care / standards
  • Reference Standards
  • Reminder Systems
  • Retrospective Studies
  • Surveys and Questionnaires


  • Antipsychotic Agents