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Vitamin D deficiency is increasing in the general population, and is linked with physical and mental illness. However, evidence on its prevalence in people with mental illness is limited. This study investigated vitamin D deficiency in 104 adult patients admitted to a psychiatric hospital in the UK.
Forty-nine per cent were vitamin D deficient (serum 25(OH)D <30 nmol/L), and a further 42.3% were vitamin D insufficient (<50 nmol/L). On admission, 8.7% of patients were vitamin D sufficient (>50 nmol/L). There were no statistically significant differences in mean serum vitamin D between different subgroups of mental illness.
Vitamin D deficiency is highly prevalent among individuals with severe mental illness admitted to hospital. Assessment and treatment of vitamin D deficiency should be considered in in-patients to protect musculoskeletal health. Further epidemiological and intervention studies are needed to investigate the role of vitamin D in the pathophysiology of mental disorders.
National clinical guidance states that patients on antipsychotics should have their metabolic profile regularly monitored. The aim of this study was to assess whether we are effectively monitoring metabolic profiles and to improve the detection, communication and intervention of metabolic abnormalities among patients on atypical antipsychotics. We describe a full audit cycle.
The audit resulted in a 24% increase in the number of patients on atypical antipsychotics being referred to the metabolic clinic. The number of abnormal results communicated to primary care showed a significant improvement of 25% (P <0.001), and ultimately the number of patients who received intervention improved by 17% (P = 0.001).
Audit feedback has been effective in changing clinical practice. The audit demonstrated the potential value of a metabolic clinic and shared care between primary and secondary practitioners for this group of high-risk patients.
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