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Monitoring and Treating Metabolic Abnormalities in Patients with Early Psychosis Initiated on Antipsychotic Medications

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Abstract

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.

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Authors and Affiliations

  1. Department of Clinical Sciences, Medical College of Wisconsin School of Pharmacy, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA

    Kevin M. Bozymski

  2. Department of Pharmacy, Eskenazi Health, 720 Eskenazi Avenue, Indianapolis, IN, 46202, USA

    Jessica A. Whitten, Mary E. Blair & Carol A. Ott

  3. Eskenazi Health Midtown Community Mental Health, 720 Eskenazi Avenue, Indianapolis, IN, 46202, USA

    Ashley M. Overley & Carol A. Ott

  4. Department of Psychiatry, Indiana University School of Medicine, 355 West 16th Street, Suite 4800, Indianapolis, IN, 46202, USA

    Ashley M. Overley & Carol A. Ott

  5. Department of Pharmacy Practice, Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN, 47907, USA

    Carol A. Ott

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  1. Kevin M. Bozymski
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  2. Jessica A. Whitten
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  3. Mary E. Blair
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  4. Ashley M. Overley
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Correspondence to Kevin M. Bozymski.

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At the time of writing, Dr. Bozymski was a PGY1 Pharmacy Practice Resident at Eskenazi Health in Indianapolis, IN.

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Bozymski, K.M., Whitten, J.A., Blair, M.E. et al. Monitoring and Treating Metabolic Abnormalities in Patients with Early Psychosis Initiated on Antipsychotic Medications. Community Ment Health J 54, 717–724 (2018). https://doi.org/10.1007/s10597-017-0203-y

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