Bipolar, schizophrenia and other psychoses: annual blood glucose or HbA1c
Indicator
The percentage of patients aged 18 years and over with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood glucose or HbA1c in the preceding 12 months.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
Antipsychotic medication used to treat people with schizophrenia, bipolar disorder or psychosis can cause an increase in blood glucose levels which increases the risk of diabetes. People with these conditions also have a higher risk of developing diabetes because of lifestyle factors, irrespective of whether they are taking antipsychotic medication. The indicator requires monitoring of blood glucose or HbA1c so that healthcare practitioners can offer preventative advice and treatment for diabetes if needed.
Source guidance
Psychosis and schizophrenia in adults: prevention and management. NICE guideline CG178 (2014), recommendations 1.1.3.6, 1.3.6.1, 1.5.3.2, 1.5.3.3
Bipolar disorder: assessment and management. NICE guideline CG185 (2014, updated 2020), recommendation 1.2.12
Specification
Numerator: The number of patients in the denominator who have a record of blood glucose or HbA1c in the preceding 12 months.
Denominator: The number of patients aged 18 and over on the mental health register with a diagnosis of psychosis, schizophrenia or bipolar affective disease.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: People with a diagnosis of diabetes for more than 12 months.
Minimum population: The indicator would be appropriate to assess performance at individual general practice level.
ISBN: 978-1-4731-6034-7