Equally Well UK are working with McPin Foundation in supporting lived experience involvement in developing PsyMetRiC, one of the first risk prediction tools specifically for psychosis in young people to be certified by the MHRA for use in real-world healthcare.
A new digital tool, developed with key input from young people with lived experience of psychosis, has been approved for use in healthcare. PsyMetRiC (Psychosis Metabolic Risk Calculator) helps to predict physical health risks in young people with psychosis who have a heightened risk of cardiometabolic disorders such as unhealthy weight, metabolic syndrome and diabetes. PsyMetRiC will help many young people with psychosis by prompting meaningful discussions and encourage shared decision-making between patients and healthcare professionals about preventative measures, interventions, and behavioural change that are acceptable, feasible and empowering.
“Psychotic disorders are typically diagnosed when people are in their late teens and early twenties, and the impact on lifestyles can be profound. People with psychosis may be less able to eat healthy food, or exercise, and may be more likely to smoke. Additionally, antipsychotic medicines could have side effects making patients feel hungrier, or more sedate, contributing to weight gain. People with psychosis may also experience healthcare and other inequalities, preventing them from receiving the same standard of physical healthcare as the rest of the population. Consequently, factors that predispose people to obesity, diabetes and heart disease, are detectable from the onset of psychosis – many years earlier than would be typical for the rest of the population.”
Dr Benjamin Perry, Associate Clinical Professor of Psychiatry from the University of Birmingham, led the development of PsyMetRiC
Although it may be possible to reverse the early signs of physical health conditions with lifestyle changes and medication, young people with psychosis often fall under the detection radar. PsyMetRiC is intended to change this, by prompting meaningful discussions between patients and health professionals, encouraging shared decision-making about preventative measures, interventions, and behavioural change. It is suitable for use in both primary and secondary care.
“It’s fantastic to see PsyMetRiC make the transition from development to clinical use, where hopefully it can help reduce the number of young people going through what I have with my mental and physical health.”
Dr Annabel Walsh, McPin Senior Public Involvement in Research Manager
PsyMetRiC in clinical practice
Existing tools used by GPs were not designed for younger people and are not accurate for individuals with psychosis. As a result, a group that could benefit most from early physical health support often misses out on these interventions.
PsyMetRiC is a web-based tool for clinicians that uses simple information routinely recorded in healthcare to estimate risk. It presents results in clear graphical and numerical formats and shows the level of uncertainty in predictions. The tool also adapts the “heart age” concept, which has been shown to encourage healthier behaviours such as quitting smoking, improving diet, and increasing physical activity. These features aim to improve understanding and support more productive conversations between clinicians and patients about health risks. The website also includes a downloadable risk-communication guide for health professionals.
The PsyMetRiC algorithms were specifically developed for young people with psychosis. They estimate the risk of clinically significant weight gain within one year, metabolic syndrome within six years, and type 2 diabetes within ten years. The models were developed and validated using anonymised routine health data from more than 25,000 young people with psychosis in the UK, with follow-up data spanning up to 20 years.
The development of PsyMetRiC involved extensive input from stakeholders, including clinicians, carers, and young people with lived experience of psychosis. Equally Well UK and McPin Foundation engaged young people with lived experience of psychosis to ensure the tool provides outcomes that are meaningful in clinical practice and important to patients.
PsyMetRiC is now registered with the Medicines and Healthcare products Regulatory Agency as a software medical device – the first prediction tool in psychiatry to achieve this status. This approval allows PsyMetRiC to be used in real-world clinical practice across Great Britain, supporting conversations between healthcare professionals and patients and helping guide shared decisions to improve the long-term physical health of young people with psychosis.
Users can sign up for a free account to use the app, after agreeing use terms, and confirming they are a health professional.
The science underlying this work is published in the Lancet Psychiatry.
