• Monitoring for Metabolic Syndrome in Patients Taking Second Generation Antipsychotic Medications

      Ditto, Jessica; Bundy, Elaine Y. (2022-05)
      Problem & Purpose: Patients taking atypical antipsychotic medications are high risk for metabolic syndrome. Metabolic syndrome occurs when there is an elevation in at least three of the following parameters: weight, blood pressure, blood glucose, abdominal circumference, or cholesterol. Clinical guidelines regarding the monitoring of metabolic parameters in patients taking atypical antipsychotic medications are not consistently followed in outpatient psychiatric offices. The purpose of this quality improvement project was to implement an office protocol based on the American Diabetes Association guidelines for the monitoring of metabolic parameters in patients taking atypical antipsychotic medications. Methods: Following staff education, a metabolic screening and patient education protocol was implemented. Educational materials were provided to patients and families, and individual providers’ rates of following several parameters were tracked weekly. Results: During project implementation, compliance with the screening protocol has improved in several areas. The percentage of patients with labs ordered began in the range of 5-10% during the first few weeks and increased to 85-95% for the remainder of the project. There was also a modest improvement in patients’ labs being returned for review, with none returned in the first weeks, but increasing to 40-50% by the end of the QI project. Other parameters that were being monitored had improvements as well. Conclusions: While there were improvements in each of the parameters, there were barriers to change in several areas. For instance, while the percentage of eligible patients with appropriate labs ordered was close to 100% by the end of the project, there were still only about 45% of those ordered that were drawn. Exploring the barriers for patients having the labs drawn would improve the care of these patients.