title: Glucose Testing for Adults Receiving Medicaid and Antipsychotics: A Population-Based Prescriber Survey on Behaviors, Attitudes, and Barriers.
abstract: This study aimed to assess provider attitudes about glucose testing for adults prescribed second-generation antipsychotic medication.
  
  
  
  Missouri Medicaid prescribers of antipsychotics in 2011 were surveyed (N=924, 25% response rate). Pearson's chi square test was used to compare responses between prescriber specialty setting. Multivariable log-binomial regression evaluated the association of factors hypothesized as barriers to screening.
  
  
  
  Prescribers in community mental health centers were more likely than primary care providers to report that they would definitely order baseline testing (57% versus 39%, p<.001) and were greater promoters of screening to colleagues (76% versus 49%, p<.001). The strongest predictor of screening intent was disagreeing strongly that "metabolic screening is not a priority for me or my organization" (94% more likely to screen at drug initiation and 74% more likely at annual evaluation, both p<.001).
  
  
  
  Establishing organizational priority across all treatment settings is important for achieving population-based diabetes screening goals for all Medicaid patients receiving antipsychotics.
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Elaine H
authors.initials: EH
authors.lastname: Morrato
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Brewer
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Campagna
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Deborah S K
authors.initials: DS
authors.lastname: Thomas
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Miller
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: John W
authors.initials: JW
authors.lastname: Newcomer
authors.affiliation: Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail: elaine.morrato@ucdenver.edu ). Dr. Morrato and Dr. Dickinson are also with the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, where Ms. Brewer and Ms. Campagna are affiliated. Dr. Thomas is with the Department of Geography and Environmental Sciences, University of Colorado Denver, Denver. Dr. Druss is with the Rollins School of Public Health, Emory University, Atlanta. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Lindrooth
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001786:Blood Glucose; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000175:diagnosis*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data*; D008923:Missouri; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose