A pilot feasibility study of nurse-led psyllium supplementation for metabolic health in hospitalized patients with schizophrenia

Background: Individuals with schizophrenia in long-term psychiatric inpatient settings face substantial cardiometabolic risk, while feasible non-pharmacological metabolic interventions remain limited within routine nursing care. Psyllium supplementation may offer a practical dietary fiber strategy that can be integrated into psychiatric nursing practice. Purpose: This study evaluated the feasibility, safety, and acceptability of a nurse-delivered psyllium supplementation protocol and explored preliminary metabolic patterns among hospitalized individuals with schizophrenia. Methods: A pilot feasibility trial was conducted in the psychiatric inpatient unit. Psychiatric nurses supervised psyllium preparation, intake, hydration monitoring, and adverse event surveillance as part of routine care. Feasibility outcomes included adherence, safety, and protocol fidelity. Exploratory metabolic indicators were assessed descriptively to inform future trial design. Results: Adherence to the nurse-delivered protocol was high, and no gastrointestinal, psychiatric, or medical adverse events were observed. Exploratory analyses indicated attenuation of early triglyceride increases and modest stabilization of central adiposity and glycemic indicators during the intervention period. Conclusions: Nurse-led psyllium supplementation was feasible and safe in a long-term psychiatric inpatient setting and generated preliminary metabolic signals that warrant further investigation. These findings highlight the potential role of psychiatric nurses in implementing proactive, non-pharmacological metabolic care for individuals with schizophrenia.