Screening for diabetes in patients receiving second-generation atypical antipsychotics

Am J Health Syst Pharm. 2015 Sep 1;72(17 Suppl 2):S70-3. doi: 10.2146/ajhp150150.

Abstract

Purpose: Results of a study to assess adherence with a consensus statement for diabetes screening in patients receiving atypical antipsychotics and to evaluate the role of pharmacists in a patient-centered medical home in improving guideline adherence are presented.

Summary: For patients prescribed atypical antipsychotics, records were reviewed for glycosylated hemoglobin (HbA1c) testing within the past 12 months. If no HbA1c results were found within that time frame, physicians were sent an alert in the patient's electronic medical record requesting an HbA1c order. Patient medical records were reviewed to analyze the number of HbA1c orders before and after pharmacist intervention. Prior to pharmacist intervention, 17 of 120 (14%) patients were screened with HbA1c. As a result of pharmacist intervention, 86 alerts were sent to physicians to order an HbA1c level, 24 (28%) of which included an order for an HbA1c level. Eleven of 24 (46%) HbA1c test results were collected during study follow-up, and one prediabetic patient was identified.

Conclusion: After pharmacist intervention, a greater number of patients receiving atypical antipsychotic medications had HbA1c levels monitored for evidence of type 2 diabetes.

MeSH terms

  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Community Pharmacy Services / organization & administration*
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Female
  • Glycated Hemoglobin
  • Guideline Adherence
  • Humans
  • Male
  • Mass Screening / organization & administration*
  • Practice Guidelines as Topic

Substances

  • Antipsychotic Agents
  • Glycated Hemoglobin A