Abstract Body

Background

There is a growing recognition of the need to address the poor physical health of people with mental illness. Multimorbidity is associated with increased use of health services and presents a challenge for clinicians and other service providers. Epidemiological evidence consistently shows that people with mental illness have higher rates of physical comorbidity, particularly those of cardiovascular and respiratory diseases. The high rate of physical comorbidity significantly reduces the life expectancy among people with mental illness who dye on average 10-15 years earlier than the general population. Consequently, people with combined mental and physical comorbidity have increased re-admission rates, higher hospital and total health sector costs than people without mental illness.

Method

This study is a retrospective cross-sectional analysis based on discharge data from an Australian Mental Health Unit Details of physical comorbidities and mental health will be extracted from the hospital discharge data for a 10-year period.

Results

The prevalence of physical health problems in participants and across different mental disorders will be reported using descriptive statistics as means and standard deviations or number and percentages as appropriate.

Conclusions

By quantifying specific physical health conditions across a range of psychiatric diagnoses, this analysis is expected to establish a prioritisation list of physical health problems in patients with different mental illnesses based on their disease and treatment burden and inform the coordination of care across the whole of hospital service and identify needs for referral pathways with other outpatient community and public health services.

Abstract Body

Abstract: Clozapine is the most effective medication for treatment refractory schizophrenia (TRS). However, there is a significant burden of adverse drug reactions. Safe and quality prescribing of clozapine requires a fine balance between management of psychotic symptoms and amelioration of the adverse drug reactions our consumers bear.

Objectives:

To provide updates regarding:

an understanding of the use of clozapine among people with complex and difficult to treat psychosis

increased awareness of the management strategies for serious clozapine adverse effects, notably constipation, pneumonia and myocarditis

guidance on how to use metformin at the time of clozapine initiation for prevention of weight gain.

Methods: The presenters will present clinical data and review the current literature on quality and safe use of clozapine. We will focus on complex psychosis, management of adverse drug effects and how to prevent clozapine-associated weight gain.

Findings: Clozapine is significantly more effective than other anti-psychotics for treatment of TRS; however, practitioners must be vigilant for adverse drug reactions, notably constipation, pneumonia and constipation, and be proactive in prevention of weight gain to reduce the risk of cardiometabolic illness.

Conclusions: At the end of this session, practitioners will be proficient in the quality and safe use of clozapine.