Handheld ECG could make physical health checks easier for people receiving mental health care

A handheld heart monitoring device could make an important physical health check easier and more accessible for people receiving mental health care, a project by Kent and Medway Mental Health NHS Trust has found.

The project explored patients’ experiences of a portable KardiaMobile 6-lead electrocardiogram (ECG), compared with a traditional 12-lead ECG. An ECG records the heart’s electrical activity and can help healthcare professionals identify problems with how the heart is working.

A traditional 12-lead ECG uses sensors placed on the chest and limbs to provide a detailed picture of the heart’s electrical activity. The handheld 6-lead ECG is a smaller device that patients hold with their fingers to record 6 electrical views of the heart. It can be used quickly and without attaching multiple sensors to the body.

ECGs are an important part of health checks for people taking some psychiatric medications. This includes clozapine, a medication used to treat some severe mental health conditions. It can sometimes be difficult for people to have an ECG, because it usually means that they need to come to a clinic, and they may find it uncomfortable.

In this project, patients who tried the handheld device reported a positive experience. 97% found it easy or very easy to use, 84% strongly preferred it to a traditional 12-lead ECG, and 92% said they would be more likely to consent to monitoring using the handheld device.

By comparison, 46% found the traditional 12-lead ECG easy or very easy to use, while 16% found it difficult or very difficult.

Madelaine Bridges, Interim Community Matron at Kent and Medway Mental Health NHS Trust and project lead, said: “Regular physical health monitoring is an important part of supporting people who take clozapine, but we know a traditional ECG is not always easy or convenient for everyone.

“These early findings are encouraging because they show that patients may welcome a simpler and more convenient approach. By listening to patients and exploring different ways of delivering care, we hope to reduce barriers and help more people complete this important annual health check.”

Building on this work, several trust colleagues are also part of the team who developed and are delivering the Easy ECG study, led by Dr George Crowther at Leeds and York Partnership NHS Foundation Trust. This is a national study that directly compares the handheld 6-lead ECG with a traditional 12-lead ECG. The study aims to find out whether the handheld device provides sufficiently reliable ECG measurements to be used safely in routine clinical care for people taking clozapine and other psychiatric medications that require heart monitoring.

Dr Jo Rodda, Consultant in Older Adult Psychiatry Kent and Medway Mental Health NHS Trust and Mental Health Teaching Lead at Kent and Medway Medical School said: “Our research is ultimately about improving care for our patients. These initial findings suggest that a handheld ECG could offer a more accessible and comfortable way of completing an important physical health check.

“The next stage is to directly compare the handheld and traditional ECGs and build the evidence we need to understand how they perform. We want to ensure that any approach we use is safe, evidence-based and improves patients’ experience and access to care.”

The initial project was classified as a clinical audit and approved by the trust’s Clinical Audit and Effectiveness Committee. The findings were presented at the Royal College of Psychiatrists International congress and published online in BJPsych Open as part of the conference proceedings.