title: Does colocated care improve access to cardiometabolic screening for patients with serious mental illness?
abstract: OBJECTIVE
  Individuals with serious mental illness (SMI; e.g., schizophrenia, bipolar disorder) experience disparities in mortality relative to the general population, mainly because of medical conditions (i.e., cardiometabolic disease).We assessed whether VA patients with SMI and receiving care from VA mental health facilities with colocated medical care were more likely to receive cardiometabolic risk assessments in accordance with clinical practice guidelines than patients from noncolocated facilities.
  
  
  METHODS
  Patients with SMI identified prescribed second-generation antipsychotic medications in fiscal year (FY) 2007 receiving care from VA mental health facilities completing the VA Mental Health Program Survey were included. VA administrative data were ascertained to assess receipt of the following tests every 6 months in FY 2007: body mass index (BMI), blood pressure, lipid profile and fasting glucose.
  
  
  RESULTS
  Out of 40,600 patients with SMI prescribed second-generation antipsychotics, 29% received all cardiometabolic tests (lipid, glucose, BMI and blood pressure). While 79% and 76% received blood pressure and BMI assessments, respectively, only 37% received a lipid test. Patients from colocated sites were more likely to receive all cardiometabolic tests (odds ratio=1.26, 95% confidence interval: 1.18-1.35, P<.001).
  
  
  CONCLUSIONS
  Colocated general medical providers in mental health clinics are more likely to provide cardiometabolic assessments for patients with SMI prescribed second-generation antipsychotics.
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI 48105, USA. amykilbo@umich.edu
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Zongshan
authors.initials: Z
authors.lastname: Lai
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bowersox
authors.forename: Paul
authors.initials: P
authors.lastname: Pirraglia
authors.forename: Mark S
authors.initials: MS
authors.lastname: Bauer
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002300:Cardiac Care Facilities / Q000458:organization & administration / Q000592:standards; D003327:Coronary Disease / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D011787:Quality of Health Care / Q000592:standards; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration / Q000592:standards
chemical_list: D001786:Blood Glucose; D008055:Lipids