Compliance to pathology guidelines during nutritional management in mental healthcare

Management of mental health disorders often include nutritional therapy, and guidelines for monitoring require pathology tests. This includes but not limited to individuals with alcohol and other drugs (AOD) and weight-control issues in cases of metabolic syndrome (obesity, hypertension, dyslipidaemia, and diabetes), which involves cardiology or cardiovascular medicine management. The extent of compliance to evidence-based practice including laboratory tests (1) , such as routine full blood count (2) , as well as electrolytes and liver function tests are considerations in evaluation of nutritional management and monitoring. The primary objective of this review is to determine compliance to guidelines in case studies involving nutritional management. The secondary objective is evaluation of the pathology results in cases of cardiovascular disease management guidelines. This was a systematic literature review and meta-analysis, which were adopted in identifying and selecting the articles appraised. Search was unlimited in years of publication. Initial search engine was PubMed, for brevity. Appraisal tool was a simple objective questionnaire based on evidence-base practice in nutritional perspective of AOD management using a reference template. Additional grey literature search was done to provide nuance to the systematic review. Compliance to evidence-based practice was quantified by calculating the percentage of expected ‘yes’ responses. On pathology tests, the focus was predominantly on coagulation profile, haematology, lipid profile and liver function tests. Among the > 548,000 titles initially identified, only three were selected for the critical appraisal and three additional documents were selected from the grey literature search. All six articles appraised, showed 98% compliance to pathology guidelines. The laboratory evidence-based monitoring was implied in five, of which four were related to cardiology and four reports indicated or inferred laboratory monitoring of dyslipidaemia, only. None of the articles mentioned coagulation profile, haematology or liver function tests. This discourse advances that for almost 30-years, there has been knowledge of a strong link between nutritional management and cardiovascular disease management including in mental healthcare, which can be assessed with eWBV from pathology (3) . There is excellent compliance to evidence-based practice in research reports involving nutritional management in mental health cases. However, laboratory evidence-based monitoring for cardiovascular medicine seems incomplete. In cognizance of cardiovascular disease management guidelines, this incompleteness may be a matter of discretion.