title: Metabolic monitoring training program implementation in the community setting was associated with improved monitoring in second-generation antipsychotic-treated children.
abstract: OBJECTIVE
  To determine whether implementation of a metabolic monitoring training program (MMTP) in an urban community-based setting improved monitoring in children treated with second-generation antipsychotics (SGAs) and changed prescription rates of SGAs to children.
  
  
  METHODS
  The MMTP was implemented in the Vancouver Coastal Health Child and Youth Mental Health Teams (CYMHTs) on January 1, 2009. A retrospective review of paper charts and electronic records for children seen at the CYMHTs from September 1, 2007, to May 1, 2010, was performed to collect the following data: age, sex, foster care, immigrant status, Axis I diagnosis, and medications. In SGA-treated children, anthropometric measurements and blood work completed at baseline and 3, 6, and 12 months were also collected.
  
  
  RESULTS
  Among the 1114 children seen pre-MMTP and 1262 children seen post-MMTP implementation, 174 (15.4%) and 81 (6.4%), respectively, were SGA-treated (P < 0.001). Among the SGA-treated children seen at the CYMHTs after MMTP implementation, 38.3% had a copy of the MMTP in their paper chart. Metabolic monitoring increased by up to 40% at baseline (P < 0.01), 20% at 3 (P < 0.01) and 6 months (P < 0.01), and 18% at 12 months after MMTP implementation.
  
  
  CONCLUSIONS
  Implementation of an MMTP was associated with significantly improved monitoring rates of anthropometric and blood work parameters at baseline and the 3- and 6-month time points, with a trend for improvement at the 12-month time point, in SGA-treated children cared for in urban community mental health clinics. In addition, a 56% decrease in SGA prescriptions was observed following MMTP implementation in this population.
authors.affiliation: University of Toronto, Toronto, Ontario.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ronsley
authors.forename: Mark
authors.initials: M
authors.lastname: Rayter
authors.forename: Derryck
authors.initials: D
authors.lastname: Smith
authors.forename: Jana
authors.initials: J
authors.lastname: Davidson
authors.forename: Constadina
authors.initials: C
authors.lastname: Panagiotopoulos
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002648:Child; D002662:Child Health Services / Q000379:methods / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000379:methods / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D050171:Dyslipidemias / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D007223:Infant; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D014150:Antipsychotic Agents