Bozymski Kevin M, Whitten Jessica A, Blair Mary E, Overley Ashley M, Ott Carol A
Department of Clinical Sciences, Medical College of Wisconsin School of Pharmacy, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
Department of Pharmacy, Eskenazi Health, 720 Eskenazi Avenue, Indianapolis, IN, 46202, USA.
Community Ment Health J. 2018 Aug;54(6):717-724. doi: 10.1007/s10597-017-0203-y. Epub 2017 Nov 11.
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.
抗精神病药物终生都有患代谢综合征的风险。这项回顾性病历审查评估了一种代谢监测临床决策支持工具(CDST)在两年内对一家早期精神病门诊诊所的163名患者进行体重、血脂、血糖和血压管理的可行性。每个参数至少有98名(60.1%)患者有记录值,记录最多的是体重,有112名(68.7%)患者。非药物干预(如临床咨询、转介到健康项目或初级保健)的CDST依从率至少为54.3%-100%,药物干预(如二甲双胍)的CDST依从率至少为33.3%-100%。虽然未发现基线心脏代谢异常,但后来分别在37名(22.7%)和35名(21.5%)患者中发现了血脂异常和肥胖。诊所的精神科医生仅为14名(8.6%)患有心脏代谢异常的患者开了药。需要更加关注身体健康,以改善这一人群的长期预后。