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接受医疗补助和抗精神病药物治疗的成年人的血糖检测:一项基于人群的关于行为、态度和障碍的处方者调查

Glucose Testing for Adults Receiving Medicaid and Antipsychotics: A Population-Based Prescriber Survey on Behaviors, Attitudes, and Barriers.

作者信息

Morrato Elaine H, Brewer Sarah E, Campagna Elizabeth J, Dickinson L Miriam, Thomas Deborah S K, Druss Benjamin G, Miller Benjamin F, Newcomer John W, Lindrooth Richard C

机构信息

Dr. Morrato and Dr. Lindrooth are with the Colorado School of Public Health and Dr. Dickinson and Dr. Miller are with the Department of Family Medicine, all at the University of Colorado Anschutz Medical Campus, Aurora (e-mail:

出版信息

Psychiatr Serv. 2016 Jul 1;67(7):798-802. doi: 10.1176/appi.ps.201500181. Epub 2016 Apr 1.

Abstract

OBJECTIVE

This study aimed to assess provider attitudes about glucose testing for adults prescribed second-generation antipsychotic medication.

METHODS

Missouri Medicaid prescribers of antipsychotics in 2011 were surveyed (N=924, 25% response rate). Pearson's chi square test was used to compare responses between prescriber specialty setting. Multivariable log-binomial regression evaluated the association of factors hypothesized as barriers to screening.

RESULTS

Prescribers in community mental health centers were more likely than primary care providers to report that they would definitely order baseline testing (57% versus 39%, p<.001) and were greater promoters of screening to colleagues (76% versus 49%, p<.001). The strongest predictor of screening intent was disagreeing strongly that "metabolic screening is not a priority for me or my organization" (94% more likely to screen at drug initiation and 74% more likely at annual evaluation, both p<.001).

CONCLUSIONS

Establishing organizational priority across all treatment settings is important for achieving population-based diabetes screening goals for all Medicaid patients receiving antipsychotics.

摘要

目的

本研究旨在评估医疗服务提供者对为服用第二代抗精神病药物的成年人进行血糖检测的态度。

方法

对2011年密苏里州医疗补助计划中抗精神病药物的开处方者进行了调查(N = 924,回应率为25%)。使用Pearson卡方检验比较不同开处方专业背景的回应情况。多变量对数二项回归分析评估了假设为筛查障碍的因素之间的关联。

结果

社区心理健康中心的开处方者比初级保健提供者更有可能报告他们肯定会开出基线检测单(57%对39%,p <.001),并且更积极地向同事推广筛查(76%对49%,p <.001)。筛查意愿的最强预测因素是强烈不同意“代谢筛查对我或我的机构来说不是优先事项”(在药物开始使用时进行筛查的可能性高94%,在年度评估时进行筛查的可能性高74%,两者p均<.001)。

结论

在所有治疗环境中确立组织层面的优先事项,对于实现为所有接受抗精神病药物治疗的医疗补助患者进行基于人群的糖尿病筛查目标非常重要。

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