H50 Physical health monitoring in those prescribed antipsychotic medication in huntingtons disease; an audit of current practice within the nhs fife huntingtons disease service

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Abstract

Aim

Huntington’s Disease is a neurodegenerative disorder with motor, cognitive and psychiatric manifestations. Antipsychotic medications can be prescribed off licence in an attempt to alleviate motor and psychiatric disturbances 1. However, they have the potential to cause metabolic syndrome 2. Given Scottish Intercollegiate Guidelines Network (SIGN) guidance of physical health monitoring in those prescribed antipsychotic medications 3, the aim of this audit was to review the current monitoring of this within the NHS Fife Huntington’s Disease Service.

Methods

Physical health monitoring in this patient cohort was quantitatively assessed against the gold standard of SIGN 131, which suggests annual glucose and lipid profile serum samples. For each patient within the service, records were obtained retrospectively via Emergency Care Summary and Clinical Portal of their current prescription and blood test results within the last 12 months.

Outcome/results

Records of all 73 patients were checked, with one unobtainable. 6 patients were yet to be tested but there was clinical suspicion and/or a family history. Of the 72 patients, 57% (n=41) were prescribed antipsychotic medication. 75% of these prescriptions were of second-generation antipsychotics, the most common being Risperidone (n=15, 34%) and Olanzapine (n=13, 30%). Physical health was monitored as guidelines suggest for just 29% of patients (n=12), with a further 15% (n=6) of patients having either glucose or lipid samples obtained within the last year.

Conclusions

The results highlight a paucity of physical health monitoring in the patient cohort, and emphasize the need to change. Therefore, these results will be distributed amongst the team in order to start a computerized record of current monitoring. The aim will be to incorporate this into clinics and our regular clinical meeting, including blood pressure and ECG and Prolactin as clinically indicated. We hope our audit will alert other clinicians to this potentially overlooked area.

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