title: Antipsychotic Cardiometabolic Side Effect Monitoring in a State Community Mental Health System.
abstract: Antipsychotic medications can cause serious cardiometabolic side effects. No recent research has broadly evaluated monitoring and strategies to improve monitoring in U.S. public mental health systems. To address this knowledge gap, we evaluated education with audit and feedback to leaders to improve cardiometabolic monitoring in a state mental health system. We used Chi square statistics and logistic regressions to explore changes in monitoring recorded in randomly sampled records over 2 years. In 2009, assessment of patients on antipsychotics was 29.6 % for cholesterol, 40.4 % for glucose, 29.1 % for triglycerides, 54.3 % for weight, 33.6 % for blood pressure, and 5.7 % for abdominal girth. In 2010, four of ten mental health centers improved their rate of adult laboratory monitoring. Overall monitoring in the state did not increase. Education for prescribers with audit and feedback to leaders can improve monitoring in some settings, but more intensive and/or prolonged interventions may be required.
authors: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA, Robert.o.cotes@emory.edu.
authors: Robert O
authors: RO
authors: Cotes
authors: Alex
authors: A
authors: de Nesnera
authors: Michael
authors: M
authors: Kelly
authors: Karen
authors: K
authors: Orsini
authors: Haiyi
authors: H
authors: Xie
authors: Greg
authors: G
authors: McHugo
authors: Stephen
authors: S
authors: Bartels
authors: Mary F
authors: MF
authors: Brunette
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D001835:Body Weight / Q000187:drug effects; D050260:Carbohydrate Metabolism / Q000187:drug effects; D002648:Child; D002784:Cholesterol / Q000097:blood; D003156:Community Mental Health Services; D016903:Drug Monitoring / Q000706:statistics & numerical data*; D000068156:Formative Feedback; D006078:Government Programs; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects; D016015:Logistic Models; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D013219:State Government; D014280:Triglycerides / Q000097:blood; D014481:United States
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol
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