Screening for the metabolic syndrome in Australia: a national survey of psychiatrists' attitudes and reported practice in patients prescribed antipsychotic drugs.

OBJECTIVE

To investigate current reported psychiatric practice in relation to screening for the metabolic syndrome in patients prescribed antipsychotic drugs within Australia.

METHOD: A postal survey of all Fellows of the Royal Australian and New Zealand College of Psychiatrists. A 28-item questionnaire inquired into different aspects of screening and monitoring for metabolic syndrome in patients on antipsychotic medication.

RESULTS

Of 3123 questionnaires sent, 955 were returned. Of respondents, 55% had no established metabolic monitoring protocol or guidelines in their work place, with 13% saying they did not know what to monitor to detect metabolic syndrome. Altogether, 76% reported there was no reliable system in place to remind them when to monitor. Fewer than 50% of respondents routinely check weight, fasting glucose or lipids in their patients on antipsychotics and under than 30% checked blood pressure. Waist circumference was routinely checked in fewer than 7% of patients. Basic monitoring equipment was reported unavailable in more than 50% of clinical settings. However, more than 80% of respondents considered monitoring for metabolic syndrome to be their responsibility and 83% felt they had a medicolegal obligation in this respect.

CONCLUSIONS

Routine screening for metabolic syndrome in patients on antipsychotic agents, by Australian psychiatrists, is inadequate. Interventions to improve screening rates need to be developed, implemented and evaluated.