1. Better Monitoring for Better Health
Cardiometabolic Monitoring in an Adult Mental Health Service:
Measure What Matters
Freyja Millar
RN (MHN)MnP DE
Better monitoring for better heath project officer
Better Monitoring for Better Health

2. Overview Metabolic Syndrome and Cardiometabolic risk assessment.
Evidence base
Better Monitoring for Better Health
Project description
Evaluation, Research
Insights
Practice change measures
Consumer, collaboration and recovery

3. Metabolic Syndrome and 2 or more of the following four criteria:
Precursor to heart disease and diabetes
Central obesity
Waist circumference – 80cm woman 94cm men
(ethnic specific)
and 2 or more of the following four criteria:
BP – 130/85 mmHg
Triglycerides- > 1.7 mmol/L or on treatment
HDL - < 1.0 men < 1.3 women or on treatment
FPG – > 5.6 mmol/L or diagnosed T2DM
International Diabetes Federation (2006).

4. Cardiometabolic ScreeningBP
Fasting lipids
HDL
Triglycerides
Fasting plasma glucose
Waist circumference / Body Mass Index (kg/m2) .
IDF(2006)

5. Evidence

6. Better Monitoring for Better Health
( )
Project Officer
Freyja Millar
RN MnP MHN DE
Eastern Health Adult Mental Health Program
Funded through an unconditional education grant from Pfizer

7. Goals
That all people who are involved with mental health services be aware of the cardio metabolic risks associated with mental illness.
That all consumers are offered screening for cardio metabolic risk.
That all consumers are provided with every opportunity to improve their cardio metabolic health.

8. The consumer drives

9. Not learnt my lesson yet
Evaluation
Not learnt my lesson yet
Eastern Health HREC approval

10. Cardio Metabolic Monitoring Protocol

11. Cardio Metabolic Monitoring Protocol

12. the consumer is the driver of this process
H.E.A.R.T
Health Promotion
Education
Assessment
Referral
Treatment & Individual Recovery Plan
the consumer is the driver of this process

13. Evaluation
Eastern Health HREC approval

14. What information matters?
Documentation where it counts.
T&IRP is the consumers document.
Evidence of collaborative care.
Working together towards a consumer goal.
Is rate of compliance with guidelines enough?
What does this really tell us about the service we provide?
Does the practice change demonstrates a meaningful benefit to the consumer?
Having a blood pressure taken or receiving health promotion? Ask the consumer.

15. Insights How do we know if we are doing a good job?
Research Vs Quality Assurance
Compliance with what?
Compared to what?
How will this help the consumer?
Evaluate using a consumer focused lens.
Consumer driven process
Evaluation needs to reflect this

16. Better Monitoring for Better Health
Project Officer
Freyja Millar
RN (MHN) MNP DE
Eastern Health Adult Mental Health Program
Funded through an unconditional education grant from Pfizer

17. References
ADA, APA, AACE, & NAASO (2004). Consensus Development Conference on Antipsychotic Drugs and Obesity and Diabetes. Journal of Clinical Psychiatry, 65(2),
Brunero, S., & Lamont, S. (2009). Systematic screening for metabolic syndrome in consumers with severe mental illness. [Article]. International Journal of Mental Health Nursing, 18(2),
Cohn, T. A., & Sernyak, M. J. (Writer) (2006b). Metabolic Monitoring for Patients Treated With Antipsychotic Medications [Article], Canadian Journal of Psychiatry: Canadian Psychiatric Association.
International Diabetes Federation (2006). The IDF consensus worldwide definition of the metabolic syndrome Retrieved 12 August 2010, from
John, A. P., Koloth, R., Dragovic, M., & Lim, S. C. B. (2009). Prevalence of metabolic syndrome among Australians with severe mental illness. The Medical Journal of Australia, 190(4),
Lambert, T. J. R., & Chapman, L. H. (2004). Diabetes, psychotic disorders and antipsychotic therapy: a consensus statement. The Medical Journal of Australia, 181(10),
Lambert, T. J. R., & Newcomer, J. W. (2009). Are the cardiometabolic complications of schizophrenia still neglected? Barriers to care. MJA, 190(4), S39-S42.
Millar, F. (2012). Better monitoring for better health. Australian Nursing Journal , 20(2), 35.
NSW Department of Health (2009a). Physical Health Care of Mental Health Consumers - Guidelines. from
NSW Department of Health (2009b). the physical health mental health handbook.
Robson, D., & Gray, R. (2007). Serious mental illness and physical health problems: A discussion paper. [doi: DOI: /j.ijnurstu ]. International Journal of Nursing Studies, 44(3),
Stanley, S., & Laugharne, J. (2010a). Clinical guidelines for the physical care of mental health consumers. In C. a. M. H. U. Community, School of Psychiatry and Clinical Neurosciences & T. U. o. W. Australia (Eds.). Perth: The University of Western Australia.
Toth, G., Clifton, A., Mala, S., & Bachner, M. (2010). Physical health care monitoring for people with serious mental illness. Cochrane Data of Systematic Reviews(3), Art. No.: CD