Download Lester Tool Natalie Jeffrey 28 Feb 2016

Lester tool: Don’t just screen, intervene.
Patients with psychosis or schizophrenia in receipt of antipsychotic medications are at greater risk of
morbidity and mortality. The Lester tool is aimed at guiding physical health screening and
management in those with psychosis or schizophrenia who are prescribed antipsychotic medication.
This accessible assessment and intervention tool based on national guidance can be used by
members of the MDT to improve patient’s physical health.
The Lester tool is based on a traffic light system and splits risk factors into the following categories:
Smoking, lifestyle and life skills, BMI, Blood pressure, Glucose regulation and blood lipids. If a patient
falls into the at risk red zone it then gives guidance on interventions within the amber zone and a
clear target within the green zone. The tool promotes smoking cessation, healthy eating and
maintaining a BMI within 18.5-24.9. It advises 150 minutes of moderate exercise per week and diet
changes. It gives guidance on parameters for blood pressure, glucose regulation and blood lipids.
It advises that every patient should have the following reviewed at initiation of antipsychotic
medication and annually thereafter: Physical examination, Family history, lifestyle review, weight,
waist circumference, BP, Glucose and lipid profile. Weight should be assessed weekly in the first 6
weeks as weight gain is an important side effect from antipsychotic medication and rapid weight
gain in the first 6 weeks can predict severe weight in the long term. At 12 weeks: lifestyle review,
weight, BP, glucose and lipids.
This tool can also be used as a visual aid to demonstrate to patients the importance of maintaining a
healthy lifestyle, areas in need of improvement and how this can be achieved. Progress into the
green zone can help to reinforce positive lifestyle choices.
Access the Lester Tool and further information at :
http://www.rcpsych.ac.uk/quality/nationalclinicalaudits/schizophrenia/nationalschizophreniaaudit/
nasresources.aspx
Dr Natalie Jeffrey
[email protected]
Physical Health Challenges in Mental Health Practice Bulletin Issue 5 2016, NHSGGC Mental Health
Services