This audit sought to determine policies adopted by NZ DHBs for monitoring metabolic parameters for people with serious mental disorders treated with second-generation antipsychotic medications. Such medications can contribute to metabolic complications and are associated with weight gain, increased triglyceride levels, reduced HDL levels and impaired glucose metabolism. After reviewing the current literature and published guidelines relevant to metabolic syndrome, the study researchers proposed a best practice guideline, combining the 2009 ‘harmonised’ definition developed by international cardiac and metabolic health organisations, with recommendations for frequency of monitoring. All 20 DHBs and one private clinic participated in the audit, which analysed metabolic monitoring policies in relation to the best practice standard. Fourteen DHBs were found to have a metabolic monitoring policy. There was considerable variation among the policies as to size (number of pages) of policies, the extent of information about metabolic syndrome contained in the policies, and their clarity when being implemented by clinicians. Only 2 of the 14 policies included a complete set of cut-off values, consistent with the literature-based guideline. Eight policies specify actions to be taken when consumers meet criteria for metabolic syndrome. Four DHBs have systems for measuring their rates of metabolic monitoring. The study researchers recommend that the Ministry of Health adopt a best practice standard in this area, and require DHBs to report against this standard.
