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Physical exam in mental health: implementation of a form to guide medical assessment of acute psychiatric inpatients

Authors Munshi T, Asmer MS, Penfold S, Pikard J, Mauer-Vakil D, Banwell E

Received 4 December 2016

Accepted for publication 16 February 2017

Published 24 May 2017 Volume 2017:9 Pages 1—7

DOI https://doi.org/10.2147/CA.S129425

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Marietta Stanton


Tariq Munshi,1,2 M Selim Asmer,1,2 Sarah Penfold,1,2 Jennifer Pikard,1,2 Dane Mauer-Vakil,1 Emma Banwell1

1School of Medicine, Queen’s University, 2Department of Psychiatry, Queen’s University, Kingston, ON, Canada

Abstract: The physical health of individuals suffering from mental illness is known to be diminished compared to the general population, with worse health outcomes and shortened life expectancy. This places a great burden on health care systems around the world. Due to stigma and clinician attitudes, it may be difficult for physicians to engage with mentally ill patients to screen for physical disease and implement physical health interventions. Engaging with these patients during acute inpatient admission is an ideal time to identify any specific problems that may be the focus of medical attention. The Canadian Government mandates that all patients admitted to hospital receive routine physical assessment as part of their care. Our study aimed to implement a form to guide physical screening for all psychiatric patients admitted to an acute inpatient Psychiatric Unit in Kingston, ON, Canada; the patients underwent two cycles of clinical audit between 2014 and 2015 to measure completion of forms. Although the completion rate decreased, the frequency of consultation with the hospitalist increased significantly between the two cycles. There was no relationship found between patient age, psychiatric diagnosis, and day of admission during the week did not affect completion of physical health screening. Further education and advocacy is needed to ensure appropriate screening of physical problems in patients admitted for psychiatric reasons. Future studies are needed to study the effectiveness of these forms and whether or not they are effective in improving health outcomes in the long term.

Keywords: physical examination, audit, health form

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