Category: Federal Forum Posters
Purpose: Metabolic syndrome is a combination of conditions including obesity, hypertension, dyslipidemia, and diabetes mellitus. Untreated metabolic syndrome can lead to an increased risk of cardiovascular events and/or death. Use of antipsychotic medications can increase the risk of developing metabolic syndrome. The VA Portland Health Care System (VAPORHCS) is not meeting a local standard of achieving compliance in monitoring A1c or fasting blood glucose (FBG). This project aims to assess metabolic monitoring compliance and the reason behind noncompliance through evaluation of a pharmacist run clinic.
Methods: A retrospective chart review will be completed for Veterans prescribed any antipsychotic medication within VAPORHCS who have not received an A1c or FBG within the past year. This chart review will collect blood pressure, body mass index, A1c and/or FBG, and a fasting lipid panel. A clinical pharmacist responsible for the Veteran’s care will order overdue labs when necessary and will contact the Veteran and the Veteran’s primary care provider with the results . The pharmacy resident will reevaluate each Veteran’s chart after 30 days to record if the ordered lab had expired or was completed by the Veteran. Each lab value obtained will be recorded as either above or below a specific marker determined by the Mental Illness Research, Education and Clinical Center (MIRECC) Initiative on Antipsychotic Management Improvement (MIAMI) guidelines for lipids, hypertension, BMI, FBG, and A1c. Previous labs spanning over three years prior to the most recent lab will be collected via chart review to assist in determining the historical incidence of metabolic abnormalities among these Veterans. Based on the information collected, the rate of Veteran compliance to lab completion and the incidence of metabolic syndrome at VAPORHCS may be determined.
Emily Burger– PGY1 Pharmacy Resident, University of Iowa College of Pharmacy, Portland, OR