Category: Federal Forum Posters
Purpose: The American Diabetes Association (ADA) issued a consensus statement in 2004 which provided a recommended timeline for metabolic monitoring of all patients who initiate any antipsychotic. This original recommendation has been widely implemented into clinical practice and has not been updated since. Follow up lab monitoring is a perceived barrier for continued treatment for some patients and providers alike. The objective of this quality improvement project is to retrospectively evaluate the use of individual atypical antipsychotic medications in a large veteran population to assess for trends and risk factors for progression to metabolic syndrome.
Methods: This is a retrospective electronic data analysis approved as a quality improvement project by the local Institutional Review Board. All Veterans within Veterans Integrated Service Network (VISN) 21 who received their first atypical antipsychotic between fiscal years 2004-2018 will be identified utilizing the VISN 21 clinical data warehouse. Once the patient cohort is identified, baseline patient characteristics, lab results, prescription data, and documented adverse effects will be queried. Upon completion of the data collection, statistical analyses will be utilized to assess for correlations between patient demographic data, the atypical antipsychotic drug used, and changes in patient characteristics and lab values. The primary outcome will be assessing the average change in A1C level and time to onset of an A1C level that is considered either pre-diabetic or diabetic stratified by the atypical antipsychotic used. Secondary outcomes will include average changes in blood pressure, BMI, weight, lipid levels, and fasting blood glucose. Patient characteristics and demographics such as age, gender, and ethnicity, will be analyzed for association with changes seen in the primary and secondary outcomes.
Results: Not applicable
Conclusion: Not applicable
Clayton Hamilton– Resident Pharmacist, Veterans Affairs, Helena, MT