title: A Randomized Controlled Trial of a Patient-Centered Approach to Improve Screening for the Metabolic Side Effects of Antipsychotic Medications.
abstract: Adherence to recommendations for monitoring of metabolic side effects of antipsychotic medications has been historically low. This randomized controlled trial tested whether a computerized, patient-centered intervention that educated Veterans with serious mental illness about these side effects and encouraged them to advocate for receipt of monitoring would increase rates of monitoring compared to enhanced treatment as usual. The mean proportion of days adherent to monitoring guidelines over the 1-year study was similarly high and did not differ between the intervention (range 0.81-0.98) and comparison (range 0.76-0.96) groups. Many individuals in both groups had persistent abnormal metabolic parameter values despite high rates of monitoring, contact with medical providers, and receipt of cardiometabolic medications. Participants exposed to the intervention were interested in receiving personalized information about their cardiometabolic status, demonstrating the preliminary feasibility of brief interventions for enhancing involvement of individuals with serious mental illness in health care decision making.
authors.affiliation: U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA. Julie.Kreyenbuhl@va.gov.|Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA. Julie.Kreyenbuhl@va.gov.
authors.forename: Julie
authors.initials: J
authors.lastname: Kreyenbuhl
authors.affiliation: Department of Psychiatry, Center for Practice Innovations, New York State Psychiatric Institute, Columbia University, New York, NY, USA.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Dixon
authors.affiliation: U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA.|Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Clayton H
authors.initials: CH
authors.lastname: Brown
authors.affiliation: U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA.|Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Medoff
authors.affiliation: U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Klingaman
authors.affiliation: Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Li Juan
authors.initials: LJ
authors.lastname: Fang
authors.affiliation: Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tapscott
authors.affiliation: U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA.
authors.forename: Mary Brighid
authors.initials: MB
authors.lastname: Walsh
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000378:metabolism*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008873:Mid-Atlantic Region; D008875:Middle Aged; D018802:Patient-Centered Care; D058996:Quality Improvement
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotic medications; Metabolic side effects; Monitoring; Randomized controlled trial