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Table 1 Example of a prescribing indicator in questionnaire format provided to the Delphi panel

From: The development and validation of a medicines optimisation tool to protect the physical health of people with severe mental illness (OPTIMISE)

Section A: Cardiovascular System
Indicator: Overweight/Obesity
1 = Strongly Agree,
5 = Strongly Disagree
 
1 2 3 4 5 Comments
Lifestyle interventions should always be part of the first line approach to reducing BMI in overweight/obese* individuals with SMI
(*WHO defines overweight as BMI ≥ 25 kg/m2 and obesity as BMI ≥ 30 kg/m2)
      
Lifestyle interventions should be continued alongside additional interventions to reduce BMI in overweight /obese individuals with SMI       
Consider adjunctive metformin, unless contraindicated, in people with SMI who are prescribed clozapine or olanzapine and who have demonstrated early weight gain*
*early weight gain is defined as 5% of body weight in the first month of treatment and is a predictor of long-term weight gain (> 15% over 3 months)