Evaluation of antipsychotic monitoring in a community health center during the COVID‐19 pandemic

Abstract

AbstractBackgroundThe coronavirus disease 2019 (COVID‐19) pandemic complicated providers' ability to appropriately monitor patients on antipsychotic medications, as visits moved to telehealth. Adverse metabolic and movement effects can be difficult to assess virtually, reducing adherence to national antipsychotic guidelines. This review was conducted to evaluate provider adherence to antipsychotic medication monitoring during the COVID‐19 pandemic, educate providers on the proper antipsychotic monitoring methods, and then reassess adherence to guidelines.MethodsThis was a retrospective chart review of patients receiving antipsychotics from mental health (MH) and primary care (PC) providers consisting of three phases. Providers prescribing antipsychotics between June 1, 2021, and June 1, 2022, were included in phase one. Patients were reviewed for relevant data including demographics, antipsychotic(s) prescribed, glucose, hemoglobin A1c, total cholesterol, low‐density lipoprotein (LDL), high‐density lipoprotein (HDL), triglycerides, weight/ body mass index (BMI), waist circumference, Abnormal Involuntary Movement Scale (AIMS), and other movement disorder assessments. Providers were then given an educational flyer outlining proper antipsychotic monitoring in October 2022 as phase two. During phase three, providers prescribing antipsychotics between October 1, 2022, and February 23, 2023, were included for review. Monitoring rates were compared to national antipsychotic guidelines, and adherence rates were calculated for each monitoring parameter. Comparisons between phase one and phase three were performed using Chi‐squares to determine statistically significant differences (p < 0.05).ResultsUnfortunately, most monitoring rates decreased from baseline to follow‐up. All metabolic parameters were statistically significantly lower in the follow‐up sample compared to the baseline sample. These differences were seen when comparing the overall sample as well as the MH and PC provider groups across time points. Movement disorder monitoring showed no statistically significant differences between timepoints, with one exception. Among PC providers, the rate of AIMS monitoring was significantly increased from baseline (0%) to follow‐up (11.1%, p = 0.000).ConclusionPharmacist passive education of clinicians alone did not provide a significant change in provider's adherence to antipsychotic monitoring.