Interventions to Improve Metabolic Risk Screening Among Adult Patients Taking Antipsychotic Medication: A Systematic...

Area of Science:

• Pharmacovigilance
• Clinical Practice Guidelines
• Health Services Research

Background:

• Antipsychotic medications are linked to significant cardiometabolic risks.
• Current clinical practice shows low adherence to metabolic risk screening guidelines for patients on antipsychotics.
• A gap exists between recommended screening practices and actual implementation in healthcare settings.

Purpose of the Study:

• To systematically review interventions aimed at improving metabolic risk screening for patients using antipsychotics.
• To evaluate the quality, strategies, and impact of these interventions on screening rates.
• To identify shortcomings and inform future interventions for the guideline-to-practice gap.

Main Methods:

• Systematic review of studies on interventions for metabolic risk screening in adult antipsychotic users.
• Data extraction on study characteristics, improvement strategies (provider, patient, system levels), and screening rates.
• Inclusion of studies published up to July 2018 from major biomedical and psychological databases.

Main Results:

• Thirty complex interventions utilizing 1-9 strategies were analyzed.
• Common strategies included social influence and clinical prompts/monitoring tools.
• Interventions significantly increased median screening rates: glucose (28% to 65%), lipids (22% to 61%), weight (19% to 67%), and blood pressure (22% to 80%).
• Most studies were assessed as having a high risk of bias.

Conclusions:

• Current interventions show limitations in quality and effectiveness for improving antipsychotic metabolic risk screening.
• Despite improvements, approximately one-third of patients remain unscreened, indicating a persistent guideline-to-practice gap.
• Future interventions require enhanced design to address identified shortcomings and improve patient outcomes.