Laurel Prescriptions, Vancouver
Wilson Pharmacy, Vancouver
Super-Care Pharmacy, Chilliwack

Metabolic Monitoring Program

Monitoring and addressing the unmet medical needs or patients taking second generation anti-psychotics

THE NLMM APPROACH

The NLMM Pharmacy team will provide metabolic monitoring protocols, and assist both the primary care provider and psychiatrist in making recommendations for Metabolic Syndrome.

It is important to take a holistic approach when managing patients, addressing both their psychiatric and physical health needs. Pharmacists are accessible and knowledgeable health care professionals, that can help monitor and make recommendations for metabolic syndrome. The value of pharmacists managing patients with metabolic syndrome was demonstrated in a large study in the Middle East. NLMM uses a similar approach which found:

  1. Metabolic components were assessed and managed collaboratively by focused care plans designed by the clinical pharmacist and approved by the physician

  2. From baseline to follow up, 39.1% of intervention group patients compared to 24.7% of usual care patients were successfully shifted from a status of metabolic syndrome to non metabolic syndrome.

  3. Pharmacist involvement in the clinical management of patients with metabolic syndrome increased the proportion of patients who no longer met the diagnostic criteria for the syndrome after 6 months follow up

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WHAT IS METABOLIC SYNDROME?

Metabolic Syndrome is defined as a group of metabolic and cardiovascular changes that occur together in the body leading to dyslipidemia, diabetes, and cardiovascular disease. Patients with major mental illnesses have an increased prevalence of overweight and obesity, hyperglycemia, dyslipidemia, hypertension, and smoking, and substantially greater mortality, compared with the general population.

Subsequently, persons with major mental disorders lose 25 to 30 years of potential life in comparison with the general population, primarily due to premature cardiovascular mortality. Other interesting facts include:

  1. Many antipsychotic medications are associated with weight gain, glucose abnormalities and/or dyslipidemias, putting these patients at risk for metabolic syndrome.

  2. The incidence of metabolic syndrome is 2-3 times higher in people with schizophrenia.

  3. New cases of metabolic syndrome are 2 timeshigher in patients receiving 2nd generation anti-psychotics versus 1st generation.