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Published Online: 1 September 2015

The Role of Clinical Setting and Management Approach in Metabolic Testing Among Youths and Adults Treated With Antipsychotics

Ginger E. Nicol, M.D., Elizabeth J. Campagna, M.S., P.Stat., Lauren D. Garfield, M.P.H., Ph.D., John W. Newcomer, M.D., Joseph J. Parks, M.D., and Elaine H. Morrato, Dr.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 67, Number 1
https://doi.org/10.1176/appi.ps.201400428
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Abstract

Objective:

This study compared metabolic screening among patients who received antipsychotic treatment at community mental health centers (CMHCs), with or without case management, and patients treated elsewhere.

Methods:

Rates of glucose and lipid testing among youths and adults in Missouri Medicaid (N=9,473) who received antipsychotic treatment at CMHCs, with and without case management, were evaluated. Multivariable logistic regressions determined which characteristics were independently associated with metabolic testing.

Results:

A total of 37.0% and 17.3% of youths and 68.7% and 34.9% of adults had glucose and lipid testing, respectively. Compared with treatment elsewhere, treatment at CMHCs, with or without case management, respectively, was associated with higher odds of glucose testing (youths, adjusted odds ratio [AOR]=1.68 and 1.89; adults, AOR=1.43 and 1.44) and lipid testing (youths, AOR=2.40 and 2.35; adults, AOR=1.97 and 1.48).

Conclusions:

CMHCs had higher rates of metabolic testing, possibly reflecting Missouri’s efforts to promote testing in these settings.

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Information & Authors

Information

Published In

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Cover: Landscape, by Louis Comfort Tiffany, ca. 1892. Stained glass. Private Collection. Photo credit: Art Resource, New York City.

Psychiatric Services
Volume 67 • Number 1 • January 01, 2016
Pages: 128 - 132
PubMed: 26325456

History

Received: 22 September 2014
Revision received: 17 March 2015
Accepted: 30 March 2015
Published online: 1 September 2015
Published in print: January 01, 2016

Authors

Details

Ginger E. Nicol, M.D.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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Elizabeth J. Campagna, M.S., P.Stat.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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Lauren D. Garfield, M.P.H., Ph.D.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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John W. Newcomer, M.D.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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Joseph J. Parks, M.D.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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Elaine H. Morrato, Dr.P.H.
Dr. Nicol is with the Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri (e-mail: [email protected]). Ms. Campagna and Dr. Morrato are with the Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Denver. Dr. Garfield is with Mercy Virtual Care Center, St. Louis. Dr. Newcomer is with the Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton. Dr. Parks is with MO HealthNet, Missouri Department of Social Services, Jefferson City, and with the Missouri Institute of Mental Health, University of Missouri–St. Louis.
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Competing Interests

Dr. Nicol has received research funding from, served as a consultant to, or served on an advisory board for Lundbeck, MedScape, NARSAD, Otsuka America Pharmaceuticals, Inc., Pfizer, Inc., and the Sidney R. Baer, Jr., Foundation. Ms. Campagna has received research grant support from Janssen Pharmaceuticals. Dr. Newcomer has received research funding from or served as a consultant to Otsuka America Pharmaceuticals, Inc., Found2Recovery, and Reviva Pharmaceuticals and has been a member of a data safety monitoring committee for Amgen. Dr. Parks has been a consultant for Otsuka America Pharmaceuticals, Inc. Dr. Morrato has received consulting fees, travel support, or research grant support from Amgen, the Consumer Healthcare Products Association, Janssen Pharmaceuticals, and Merck & Co., Inc. The other authors report no financial relationships with commercial interests.

Funding Information

National Heart and Lung Institute10.13039/501100000850: T32 HL 007456
National Institutes of Health10.13039/100000002: K23 MH 092435, R21 MH 097045
US National Institute of Health: R21 MH 097045
This work was supported by the Missouri Institute for Mental Health, affiliated with the University of Missouri–St. Louis; MO HealthNet (Medicaid); the Missouri Department of Mental Health; and National Institutes of Health grants R21 MH 097045 and K23 MH 092435.

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