Authors' recommendations: The NICE clinical guideline on schizophrenia recommends that GPs and other primary healthcare professionals should monitor the physical health of people with schizophrenia at least once a year. The assessment should focus on cardiovascular disease risk assessment. Physical health reviews for people with schizophrenia and other serious mental illness form part of the National Quality and Outcomes Framework. An initial audit of 12 general practices in Bradford and Airedale revealed that while all practices had a case register of people with serious mental illness, none of the patient records examined reported a formal assessment of cardiovascular risk. Only 37% of patients had a record of cholesterol within the past 15 months. If these data are representative, there is a clear need to improve physical health monitoring and risk assessment for people with serious mental illness in Bradford and Airedale. There is good evidence that people with mental illness are at higher risk of cardiovascular disease compared with the general population. Risk assessment allows people to be offered effective treatment on an individual basis. There is robust evidence that treatment with statins reduces cardiovascular events and mortality in people at high risk of cardiovascular disease but without clinical evidence of disease. NICE considers statin therapy to be cost-effective for people with a 5-year risk of cardiovascular disease of 20% or more. Systematic reviews provide some evidence that non-pharmacological interventions can promote weight loss in people with schizophrenia. There is limited evidence of the effectiveness of smoking cessation interventions for people with schizophrenia. A Cochrane review of this topic is likely to provide up-to-date evidence in the near future. Implementing the NICE recommendation more fully would be expected to lead to a decrease in health inequality, an issue highlighted by the Disability Rights Commission. Although the NICE guideline envisages physical health monitoring taking place mainly in primary care, all health professionals who work with people with severe mental illness have a responsibility for monitoring physical health as appropriate for the individual‟s mental health state and social circumstances.

Project Status: Completed

Year Published: 2009

URL for published report: http://www.york.ac.uk/inst/crd/pdf/Physical%20health%20briefing.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: University of York