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A Randomized Controlled Trial of a Patient-Centered Approach to Improve Screening for the Metabolic Side Effects of
Julie Kreyenbuhl1,2, Lisa B Dixon3, Clayton H Brown4,5
1U.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.
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.
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