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Published on: November 21, 2013
Monitoring and Treating Metabolic Abnormalities in Patients with Early Psychosis Initiated on Antipsychotic
Kevin M Bozymski1, Jessica A Whitten2, Mary E Blair2
1Department of Clinical Sciences, Medical College of Wisconsin School of Pharmacy, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA. kbozymski@mcw.edu.
Abstract:
Antipsychotic medications carry an established lifetime risk of metabolic syndrome. This retrospective chart review evaluated feasibility of a metabolic monitoring clinical decision support tool (CDST) for weight, lipid, blood glucose, and blood pressure management of 163 clients in an early psychosis outpatient clinic over 2 years. Each parameter had at least 98 (60.1%) clients with a recorded value, the most being documented for weight with 112 (68.7%) clients. CDST adherence ranged from at least 54.3-100% for non-pharmacologic interventions (e.g. clinic counseling, referral to health program or primary care) and at least 33.3-100% for pharmacologic interventions (e.g. metformin). Though no baseline cardiometabolic abnormalities were identified, dyslipidemia and obesity were later found in 37 (22.7%) and 35 (21.5%) clients, respectively. Only 14 (8.6%) clients were prescribed medications for cardiometabolic abnormalities by psychiatrists in the clinic. Increasing focus on physical health is needed to better this population's long-term prognosis.
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