Lipid Screening Underutilized in Adults on Antipsychotics

JUNE 06, 2016
MD Magazine Staff
Study findings from the University of Colorado Anschutz Medical Campus suggest that lipid screening appears to remain particularly underutilized in adults taking antipsychotic medications, despite improvements in recent years in the use of diabetes screening in this patient population.
With previous studies showing that adults with serious mental illness die 20 to 30 years earlier than their cohorts—largely because of increased risk for diabetes, high cholesterol, high blood pressure, and heart disease—and antipsychotics shown to increase this risk even more, the American Diabetes Association and American Psychiatric Association have recommended intensive diabetes and lipid screening for patients who are on antipsychotics. The current study was conducted to determine if screening rates remained low, as determined in prior research.
“Antipsychotic medications are associated with substantial weight gain, as well as changes in insulin sensitivity and lipid metabolism, which increase the risk of diabetes and cardiovascular disease,” said lead author Elaine Morrato, DrPH, MPH, CPH, Associate Dean and Associate Professor in the Department of Health Systems, Management & Policy for the Colorado School of Public Health, at the University of Colorado Anschutz Medical Campus.
Morrato and colleagues did find that progress had been made in diabetes screening among the study population, when compared with prior reports. Their study, published May 11 in JAMA Psychiatry, included 9,316 adults aged 18 to 64 years who were starting antipsychotic medication. Secondary analysis included the subset of patients for whom prescriber knowledge, attitudes, and behavior survey data were available. Generalized estimating equations were performed to identify factors associated with failure to receive annual testing during antipsychotic treatment.

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