title: Management of new hyperglycemia in patients prescribed antipsychotics.
abstract: OBJECTIVE
  This study examined the extent to which patients found to have clinically significant hyperglycemia after beginning a new antipsychotic receive guideline concordant management.
  
  
  METHODS
  This retrospective cohort analysis (N=403) used U.S. Department of Veterans Affairs databases and multivariable logistic regression models to examine the association of patient characteristics with the likelihood of receiving recommended management.
  
  
  RESULTS
  Overall, 63% of patients (N=254) received at least one type of management action within 30 days of identification of hyperglycemia. A primary care encounter was the most common action. Weight management program encounter, nutrition encounter, diabetes clinic encounter, and change in antipsychotic medications were underutilized interventions. Counseling related to weight management, nutrition, and diabetes that occurred during other visits with providers was not measured. Older patients and female patients were less likely to receive timely management. Preexisting comorbidities inconsistently influenced management practices.
  
  
  CONCLUSIONS
  Timely hyperglycemia management actions were not recorded in administrative data for a sizable minority of patients. Further research is needed to determine the full extent of appropriate management actions in this context.
authors.affiliation: The authors are with the Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock (e-mail: kristen.viverito@va.gov ). Dr. Owen is also with the Department of Psychiatry and Dr. Li is also with the Division of Pharmaceutical Evaluation and Policy, both at the University of Arkansas for Medical Sciences, Little Rock.
authors.forename: Kristen
authors.initials: K
authors.lastname: Viverito
authors.forename: Richard
authors.initials: R
authors.lastname: Owen
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mittal
authors.forename: Chenghui
authors.initials: C
authors.lastname: Li
authors.forename: James Silas
authors.initials: JS
authors.lastname: Williams
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D061665:Time-to-Treatment; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents