Antipsychotic prescribing CQUIN
Update on local CQUIN: Initiating antipsychotic treatment and associated monitoring
Life expectancy in people with schizophrenia is reduced by 20%, with 60% of the excess mortality due to physical illness. This may be partly explained by the higher prevalence of smoking, poor diet and lack of exercise in people with schizophrenia than in the general population. As a consequence the prevalence of type 2 diabetes and cardiovascular disease is increased. In addition to lifestyle factors, the illness itself may be a risk factor for some medical conditions. An association between schizophrenia and diabetes is well recognised and antipsychotic drugs, particularly second generation drugs, have metabolic consequences that may contribute to the risk through weight gain, impact on the lipid profile, and insulin function.
Improved communication to GP colleagues from NTW – once a patient is initiated on an antipsychotic – is one of our locally commissioned CQUINs in the North of Tyne, Gateshead and South Tyneside areas, designed to help improve care.
You should be starting to see this improved communication in the form of a standardised letter, and a two week follow up, a copy of which are enclosed with this communication.
This complements the implementation of a national, mandatory CQUIN in relation to physical healthcare – which adopts NICE guidelines and use of the LESTER tool http://www.england.nhs.uk/2014/06/13/lester-tool/
The link to the antipsychotic leaflet changes depending on the GP address i.e. for Northumberland, North Tyneside, Gateshead and Newcastle the APC link is inserted into the letter:
http://www.northoftyneapc.nhs.uk/shared-care-group/information-leaflets/
For South Tyneside the NECS link:
https://medicines.necsu.nhs.uk/guidelines/south-tyneside-guidelines/
The documents at these links detail the monitoring requirements for adult patients prescribed antipsychotics. These guidelines represent a recommended standard for the majority of patients. However, monitoring should be tailored to each individual patient as some patients may require more frequent monitoring e.g. because of increased cardiac risk.