Overcoming hurdles to achieving good physical health in patients treated with atypical antipsychotics

Hurdles that must be overcome in order to implement guidelines and maximize physical health in patients treated with antipsychotics include the impression that a disruption in physical health is an inevitable token for the patient to pay in order to achieve and maintain his or her mental health; lack of routine monitoring; lack of defined care pathways for evaluation, monitoring and treatment of physical health issues in psychiatry; the burden of guideline implementation on mental health team resources; the difficulty to perform certain procedures (e.g. monitoring of waist circumference); and reluctance to switch medications once physical health effects are recognized, especially if the psychiatric symptoms are under relatively good control. It is imperative that we act now to overcome these hurdles and maximize outcomes for our patients. Strategies include establishing simple, consistent processes for physical health monitoring and tracking in clinical practice; provision of appropriate equipment to staff; effective education of all personnel involved in the care of psychiatric patients regarding this important topic; and consideration of a medication switch in patients whose medication is a high-risk contributory factor to poor physical health.