Original Article
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World J Psychiatr. Sep 22, 2014; 4(3): 56-61
Published online Sep 22, 2014. doi: 10.5498/wjp.v4.i3.56
Psychiatrists’ approach to vascular risk assessment in Latin America
Pablo Richly, Pablo López, Ezequiel Gleichgerrcht, Daniel Flichtentrei, María Prats, Ricardo Mastandueno, Julián Bustin, Marcelo Cetkovich-Bakmas
Pablo Richly, Pablo López, Ezequiel Gleichgerrcht, Julián Bustin, Marcelo Cetkovich-Bakmas, INECO (Institute of Cognitive Neurology), Buenos Aires C1126AAB, Argentina
Pablo Richly, Pablo López, Ezequiel Gleichgerrcht, Julián Bustin, Marcelo Cetkovich-Bakmas, Institute of Neurosciences, Favaloro University, Buenos Aires C1093AAS, Argentina
Pablo Richly, Marcelo Cetkovich-Bakmas, UDP-INECO Foundation, Diego Portales University, Santiago de Chile 8370076, Chile
Daniel Flichtentrei, María Prats, Ricardo Mastandueno, Intramed, Buenos Aires B1636AJK, Argentina
Author contributions: Richly P, Bustin J and Cetkovich-Bakmas M designed the study; Flichtentrei D, Prats M and Mastandueno R provided substantial contributions to acquisition of data; López P and Gleichgerrcht E provided substantial contributions to analysis and interpretation of data; Richly P and López P wrote the manuscript.
Correspondence to: Pablo Richly, MD, Head of Memory Clinic, INECO (Institute of Cognitive Neurology), Pacheco de Melo 1854, Buenos Aires C1126AAB, Argentina. prichly@ineco.org.ar
Telephone: +54-11-48120010 Fax: +54-11-48120010
Received: April 15, 2014
Revised: July 16, 2014
Accepted: August 27, 2014
Published online: September 22, 2014
Processing time: 157 Days and 1.2 Hours
Abstract

AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.

METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards cardiovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients: (1) that suffered from overweight and/or obesity; (2) whose lipids and glycemia were controlled by the physician; (3) that were questioned by, and received information from the physician about smoking; and (4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options.

RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales (χ2 = 404.9; P < 0.001), sphygmomanometers (χ2 = 419.3; P < 0.001), and measuring tapes (χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics (Z = -11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population (Z = -3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists (Z = -7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did (Z = -2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure (χ2 = 334.987; P < 0.001), weight (χ2 = 435.636; P < 0.001) and waist perimeter (χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients more frequently (Z = -2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently (Z = -7.53; P < 0.001).

CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.

Keywords: Antipsychotics; Metabolic syndrome; Psychiatric patients; Schizophrenia; Vascular risk factors

Core tip: This is a descriptive, cross sectional study that surveyed Latin-American physicians to explore the way in which Latin-American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication. We surveyed 1185 general physicians and 792 psychiatrists. We found that psychiatrists usually check vascular risk factors in their patients, especially those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.