Hostname: page-component-669899f699-7tmb6 Total loading time: 0 Render date: 2025-04-25T16:37:02.803Z Has data issue: false hasContentIssue false
  • English
  • Français

Introduction of point-of-care blood testing in early intervention in psychosis services: effects on physical health screening

Published online by Cambridge University Press:  11 April 2025

Monty Lyman Open the ORCID record for Monty Lyman [Opens in a new window] ,
Jack B. Fanshawe ,
Joshua Brewin ,
Thomas R. Fanshawe ,
Philip J. Turner Open the ORCID record for Philip J. Turner [Opens in a new window] ,
Margaret Glogowska ,
Ian Smith ,
Sarah Amani ,
Gail Hayward  and
Belinda Lennox Open the ORCID record for Belinda Lennox [Opens in a new window]
Monty Lyman*
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Oxford, UK
Jack B. Fanshawe
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Oxford, UK
Joshua Brewin
Affiliation:
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
Thomas R. Fanshawe
Affiliation:
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
Philip J. Turner
Affiliation:
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
Margaret Glogowska
Affiliation:
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
Ian Smith
Affiliation:
Department of Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Sarah Amani
Affiliation:
Dorset Healthcare University NHS Foundation Trust, Poole, Dorset, UK
Gail Hayward
Affiliation:
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
Belinda Lennox
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK Oxford Health NHS Foundation Trust, Oxford, UK
*
Correspondence: Monty Lyman. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is a significant mortality gap between the general population and people with psychosis. Completion rates of regular physical health assessments for cardiovascular risk in this group are suboptimal. Point-of-care testing (POCT) for diabetes and hyperlipidaemia – providing an immediate result from a finger-prick – could improve these rates.

Aims

To evaluate the impact on patient–clinician encounters and on physical health check completion rates of implementing POCT for cardiovascular risk markers in early intervention in psychosis (EIP) services in South East England.

Method

A mixed-methods, real-world evaluation study was performed, with 40 POCT machines introduced across EIP teams in all eight mental health trusts in South East England from March to May 2021. Clinician training and support was provided. Numbers of completed physical health checks, HbA1c and lipid panel blood tests completed 6 and 12 months before and 6 months after introduction of POCT were collected for individual patients. Data were compared with those from the South West region, which acted as a control. Clinician questionnaires were administered at 2 and 8 months, capturing device usability and impacts on patient interactions.

Results

Post-POCT, South East England saw significant increases in HbA1c testing (odds ratio 2.02, 95% CI 1.17–3.49), lipid testing (odds ratio 2.38, 95% CI 1.43–3.97) and total completed health checks (odds ratio 3.61, 95% CI 1.94–7.94). These increases were not seen in the South West. Questionnaires revealed improved patient engagement, clinician empowerment and patients’ preference for POCT over traditional blood tests.

Conclusions

POCT is associated with improvements in the completion and quality of physical health checks, and thus could be a tool to enhance holistic care for individuals with psychosis.

Keywords

Psychotic disorders/schizophreniacomorbiditydiagnostic medicinemedical technologyout-patient treatment
Type
Original Article
Information
The British Journal of Psychiatry , First View , pp. 1 - 6
Check for updates
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Hjorthøj, C, Stürup, AE, McGrath, JJ, Nordentoft, M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4: 295–301.CrossRefGoogle ScholarPubMed
Miller, C, Bauer, MS. Excess mortality in bipolar disorders. Curr Psychiatry Rep 2014; 16: 499.CrossRefGoogle ScholarPubMed
Nielsen, RE, Banner, J, Jensen, SE. Cardiovascular disease in patients with severe mental illness. Nat Rev Cardiol 2021; 18: 136–45.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Psychosis and Schizophrenia in Adults: Prevention and Management (Clinical Guideline CG178). NICE, 2014.Google Scholar
Royal College of Psychiatrists. National Clinical Audit of Psychosis – National Report for the Core Audit 2018. Healthcare Quality Improvement Partnership, 2018.Google Scholar
National Institute for Health and Care Excellence. Adult Mental Health: Serious Mental Illness, Community, Acute and Crisis Care. NICE, 2024 (https://stpsupport.nice.org.uk/adult-mental-health/index.html).Google Scholar
Butler, J, de Cassan, S, Turner, P, Lennox, B, Hayward, G, Glogowska, M. Mental healthcare clinician engagement with point of care testing; a qualitative study. BMC Psychiatry 2021; 21: 73.CrossRefGoogle ScholarPubMed
Butler, J, de Cassan, S, Glogowska, M, Fanshawe, TR, Turner, P, Walton, D, et al. Effect of point of care blood testing on physical health check completion in mental health services: mixed-methods evaluation. BJPsych Open 2020; 6: e127.CrossRefGoogle ScholarPubMed
NHS England (South). 2015-16 South Region EIP Programme Report. NHS England, 2017 (https://time4recovery.com/wp-content/uploads/2016/05/2015-16-South-Region-EIP-Programme-Report-Final.pdf).Google Scholar
Bates, D, Mächler, M, Bolker, B, Walker, S. Fitting linear mixed-effects models using lme4. J Stat Softw 2015; 67: 1–48.CrossRefGoogle Scholar
Braun, V, Clarke, V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.CrossRefGoogle Scholar
NHS England. NHS Mental Health Implementation Plan 2019/20–2023/24. NHS England, 2019 (https://www.longtermplan.nhs.uk/wp-content/uploads/2019/07/nhs-mental-health-implementation-plan-2019-20-2023-24.pdf).Google Scholar
Atkins, M, Taylor, D, Harland, R, Brewer, A, Williams, S, Chesney, E, et al, . Acceptability of point of care testing for antipsychotic medication levels in schizophrenia. Psychiatry Res Commun 2022; 2: 100070.CrossRefGoogle Scholar
Office for National Statistics. Explore Local Statistics: South East. ONS, 2024 (https://explore-local-statistics.beta.ons.gov.uk/areas/E12000008-south-east/indicators#get-the-data).Google Scholar
Schnell, O, Crocker, JB, Weng, J. Impact of HbA1c testing at point of care on diabetes management. J Diabetes Sci Technol 2017; 11: 611–7.CrossRefGoogle ScholarPubMed
Supplementary material: File

Lyman et al. supplementary material

Lyman et al. supplementary material
Download Lyman et al. supplementary material(File)
File 16.6 KB
Submit a response

eLetters

No eLetters have been published for this article.