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A Randomized Controlled Trial of a Patient-Centered Approach to Improve Screening for the Metabolic Side Effects of Antipsychotic Medications

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Abstract

Adherence to recommendations for monitoring of metabolic side effects of antipsychotic medications has been historically low. This randomized controlled trial tested whether a computerized, patient-centered intervention that educated Veterans with serious mental illness about these side effects and encouraged them to advocate for receipt of monitoring would increase rates of monitoring compared to enhanced treatment as usual. The mean proportion of days adherent to monitoring guidelines over the 1-year study was similarly high and did not differ between the intervention (range 0.81–0.98) and comparison (range 0.76–0.96) groups. Many individuals in both groups had persistent abnormal metabolic parameter values despite high rates of monitoring, contact with medical providers, and receipt of cardiometabolic medications. Participants exposed to the intervention were interested in receiving personalized information about their cardiometabolic status, demonstrating the preliminary feasibility of brief interventions for enhancing involvement of individuals with serious mental illness in health care decision making.

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Acknowledgments

This study was funded by a U.S. Department of Veterans Affairs Health Services Research and Development Merit Award (IIR-07-256) to Dr. Kreyenbuhl. It is the result of work supported with resources and the use of facilities at the VISN 5 Mental Illness Research, Education, and Clinical Center (MIRECC). Dr. Klingaman was also supported by the U.S. Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment. This work reflects the authors’ personal views and in no way represents the official view of the Department of Veterans Affairs of the U.S. Government.

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Authors and Affiliations

  1. U.S. Department of Veterans Affairs Capitol Healthcare Network (VISN 5), Mental Illness Research, Education, and Clinical Center (MIRECC), 10 North Greene Street (BT/MIRECC), Baltimore, MD, 21201, USA

    Julie Kreyenbuhl, Clayton H. Brown, Deborah R. Medoff, Elizabeth A. Klingaman & Mary Brighid Walsh

  2. Division of Psychiatric Services Research, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA

    Julie Kreyenbuhl, Deborah R. Medoff & Li Juan Fang

  3. Department of Psychiatry, Center for Practice Innovations, New York State Psychiatric Institute, Columbia University, New York, NY, USA

    Lisa B. Dixon

  4. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA

    Clayton H. Brown

  5. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Stephanie Tapscott

Authors
  1. Julie Kreyenbuhl
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  2. Lisa B. Dixon
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  3. Clayton H. Brown
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  4. Deborah R. Medoff
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  5. Elizabeth A. Klingaman
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  6. Li Juan Fang
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  7. Stephanie Tapscott
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  8. Mary Brighid Walsh
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Corresponding author

Correspondence to Julie Kreyenbuhl.

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The authors declare no conflicts of interest, and all authors certify responsibility for this manuscript.

Ethical Standard

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee of the University of Maryland, Baltimore and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Kreyenbuhl, J., Dixon, L.B., Brown, C.H. et al. A Randomized Controlled Trial of a Patient-Centered Approach to Improve Screening for the Metabolic Side Effects of Antipsychotic Medications. Community Ment Health J 53, 163–175 (2017). https://doi.org/10.1007/s10597-016-0007-5

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  • DOI: https://doi.org/10.1007/s10597-016-0007-5

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