Cotes Robert O, de Nesnera Alex, Kelly Michael, Orsini Karen, Xie Haiyi, McHugo Greg, Bartels Stephen, Brunette Mary F
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA,
Community Ment Health J. 2015 Aug;51(6):685-94. doi: 10.1007/s10597-015-9833-0. Epub 2015 Feb 3.
Antipsychotic medications can cause serious cardiometabolic side effects. No recent research has broadly evaluated monitoring and strategies to improve monitoring in U.S. public mental health systems. To address this knowledge gap, we evaluated education with audit and feedback to leaders to improve cardiometabolic monitoring in a state mental health system. We used Chi square statistics and logistic regressions to explore changes in monitoring recorded in randomly sampled records over 2 years. In 2009, assessment of patients on antipsychotics was 29.6 % for cholesterol, 40.4 % for glucose, 29.1 % for triglycerides, 54.3 % for weight, 33.6 % for blood pressure, and 5.7 % for abdominal girth. In 2010, four of ten mental health centers improved their rate of adult laboratory monitoring. Overall monitoring in the state did not increase. Education for prescribers with audit and feedback to leaders can improve monitoring in some settings, but more intensive and/or prolonged interventions may be required.
抗精神病药物可导致严重的心脏代谢副作用。近期尚无研究全面评估美国公共心理健康系统中的监测情况以及改善监测的策略。为填补这一知识空白，我们评估了对领导者进行审核与反馈的教育方式，以改善某州心理健康系统中的心脏代谢监测。我们使用卡方统计和逻辑回归来探究在两年内随机抽取的记录中监测情况的变化。2009年，接受抗精神病药物治疗患者的胆固醇评估率为29.6%，血糖评估率为40.4%，甘油三酯评估率为29.1%，体重评估率为54.3%，血压评估率为33.6%，腹围评估率为5.7%。2010年，十分之四的心理健康中心提高了其对成人的实验室监测率。该州的总体监测情况并未增加。对开处方者进行审核并向领导者反馈的教育方式可在某些情况下改善监测，但可能需要更强化和/或更持久的干预措施。
