Glucose Testing for Adults Receiving Medicaid and Antipsychotics: A Population-Based Prescriber Survey on Behaviors, Attitudes, and Barriers

Psychiatr Serv. 2016 Jul 1;67(7):798-802. doi: 10.1176/ Epub 2016 Apr 1.


Objective: This study aimed to assess provider attitudes about glucose testing for adults prescribed second-generation antipsychotic medication.

Methods: Missouri Medicaid prescribers of antipsychotics in 2011 were surveyed (N=924, 25% response rate). Pearson's chi square test was used to compare responses between prescriber specialty setting. Multivariable log-binomial regression evaluated the association of factors hypothesized as barriers to screening.

Results: Prescribers in community mental health centers were more likely than primary care providers to report that they would definitely order baseline testing (57% versus 39%, p<.001) and were greater promoters of screening to colleagues (76% versus 49%, p<.001). The strongest predictor of screening intent was disagreeing strongly that "metabolic screening is not a priority for me or my organization" (94% more likely to screen at drug initiation and 74% more likely at annual evaluation, both p<.001).

Conclusions: Establishing organizational priority across all treatment settings is important for achieving population-based diabetes screening goals for all Medicaid patients receiving antipsychotics.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, N.I.H., Extramural

MeSH terms

  • Antipsychotic Agents / therapeutic use*
  • Blood Glucose*
  • Community Mental Health Services / statistics & numerical data*
  • Diabetes Mellitus / diagnosis*
  • Drug Prescriptions / statistics & numerical data*
  • Humans
  • Medicaid / statistics & numerical data*
  • Missouri
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • United States


  • Antipsychotic Agents
  • Blood Glucose