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Metabolic Syndrome at an Outpatient Clinic for Bipolar Disorders: A Case for Systematic Somatic Monitoring
Mirjam Simoons1, Hans Mulder1, Bennard Doornbos1
1Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands (Simoons, Mulder); Interdisciplinary Centre for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands (Simoons, Schoevers, Ruhé); Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom (Ruhé); Outpatient Clinics and Department of Specialized Training, Psychiatric Hospital Mental Health Services Drenthe, Assen, the Netherlands (Mulder, Doornbos, Raats, Cath); Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen (Bruggeman); Unit of Pharmacotherapy, Epidemiology, and Economics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands, and Department of Clinical Pharmacy and Clinical Pharmacology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands (van Roon).
Objectives:
The primary objective of the study was to determine whether the Monitoring Outcomes of Psychiatric Pharmacotherapy (MOPHAR) program improved somatic monitoring practices at an outpatient clinic for bipolar disorders in the Netherlands. The secondary objective was to determine in MOPHAR the frequency of metabolic syndrome (compared with its measurability before MOPHAR) and treatment thereof.
Methods:
Frequencies of physical examinations and laboratory tests before (retrospectively) and after (prospectively) the active introduction of MOPHAR were compared among adult patients (N=155).
Results:
A median of three measurements (range 0-19) per patient were performed before MOPHAR, compared with 24 measurements (range 3-24) after MOPHAR (p<0.001). MOPHAR revealed somatic abnormalities previously unknown to treating physicians. Metabolic syndrome was present in 53% of patients; of these, 98% were not known to have metabolic syndrome before MOPHAR.
Conclusions:
Introducing a monitoring program largely improved knowledge regarding metabolic abnormalities, which are frequently present among patients with bipolar disorder.
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