Physical health examination in outpatients with schizophrenia : the cost effectiveness of laboratory screening tests

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Eskelinen , S , Suvisaari , J V J & Suvisaari , J M 2020 , ' Physical health examination in outpatients with schizophrenia : the cost effectiveness of laboratory screening tests ' , Annals of General Psychiatry , vol. 19 , no. 1 , 70 . https://doi.org/10.1186/s12991-020-00321-3

Title: Physical health examination in outpatients with schizophrenia : the cost effectiveness of laboratory screening tests
Author: Eskelinen, Saana; Suvisaari, Janne V. J.; Suvisaari, Jaana M.
Contributor: University of Helsinki, HUS Psychiatry
University of Helsinki, HUSLAB
Date: 2020-12-11
Number of pages: 8
Belongs to series: Annals of General Psychiatry
ISSN: 1744-859X
URI: http://hdl.handle.net/10138/324502
Abstract: Background Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied. Methods The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results. Results A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5euro for glucose, all lipids and sodium, and below 10euro for creatinine and gamma glutamyltransferase. Potassium (130euro), pH-adjusted ionized calcium (33 euro) and thyroid stimulating hormone (33euro) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients. Conclusions An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.
Subject: Schizophrenia
Physical
Somatic
Screening
Laboratory
FATTY LIVER-DISEASE
PSYCHIATRIC-PATIENTS
PSYCHOTIC DISORDERS
THYROID-FUNCTION
VITAMIN-D
PEOPLE
PREVALENCE
RISK
METAANALYSIS
MORTALITY
3124 Neurology and psychiatry
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