(VP063) IMPLEMENTATION OF A NURSE-DRIVEN CARDIO-PSYCHIATRY CLINIC FOR CARDIOVASCULAR PRIMARY PREVENTION IN INDIVIDUALS WITH SEVERE MENTAL ILLNESS

Background: Individuals with severe mental health illness (SMI), such as schizophrenia, schizoaffective disorder, and bipolar I disorder, have a risk for cardiovascular (CV) disease more than twice that of the general population. This is caused by a multitude of interconnected factors, including the high prevalence of nearly all modifiable cardiovascular risk behaviours and conditions, psychopharmacotherapy, and disparities in access and quality of care. Proactive identification of cardiovascular risk factors and overall risk determination for CV related events is crucial in optimizing patient outcomes. Thus, the objective of our study was to develop a cardio-psychiatry clinic to specifically screen individuals with SMI and no known CV disease for CV risk factors and to provide appropriate resources and evidence-based treatment.

METHODS AND RESULTS: Patients were referred from an outpatient psychiatry clinic to a newly developed, nurse-driven cardio-psychiatry clinic between November and April 2023. Patients were eligible if they had SMI and no known CV disease. At the initial visit, a specially trained nurse screened patients for CV risk behaviours and conditions. Pre-existing and newly identified CV risk factors were recorded. The 10-year Framingham Risk Score was calculated. Treatment was initiated for CV risk factors in conjunction with a consultant cardiologist when indicated by evidence-based guidelines.

There were 18 participants evaluated at the cardio-psychiatry clinic (age 51.4±12.3 years; 33% female). The most common SMI was schizophrenia (61%). The mean 10-year Framingham Risk Score was reported as 12.7±7.3%. The most prevalent known CV risk factors were smoking (61%) and obesity (56%; see Figure). One-third of participants (33%) had new CV risk factors identified and had pharmacological treatment initiated; the new diagnoses were diabetes (N=2), metabolic syndrome (N=4), dyslipidemia (N=5), and hypertension (N=3).

Conclusion: The new developed clinic represents a collaborative effort between cardiology and psychiatry. Our study demonstrated the utility of cardiovascular screening and treatment initiation in a highly vulnerable population. Larger scale efforts are needed to address the lack of access to quality CV care in individuals with SMI.