Improved Prescriber Adherence to Guidelines on Antipsychotic Medication Management Through Increased Access to Metabolic Monitoring Forms

Abstract

INTRODUCTION: Patients diagnosed with a chronic mental illness have a 2 to 3 times higher likelihood of developing metabolic abnormalities than their non–mentally ill counterparts due to prescription medication use. Metabolic syndrome has been reported in 52% of patients prescribed atypical antipsychotic medications, compared to the general population rate of 23%, and has been found to place individuals at high risk of death from diabetes and cardiovascular disease. AIM: This quality improvement project aimed to increase the rate of metabolic monitoring and related lab orders for patients prescribed atypical antipsychotic medications in a rural community mental health center to improve patient outcomes. METHOD: The use of a metabolic monitoring tool was implemented onsite. Chart audits were used to assess the effectiveness of introducing a metabolic monitoring form at a rural community mental health center and explore the feasibility of implementing a metabolic monitoring tool organization-wide. RESULTS: Metabolic lab orders increased from 1 to 59 at 8 weeks postimplementation for Clinic A after the implementation of a metabolic monitoring tool. CONCLUSION: Prescriber lab order rates improved using a metabolic monitoring form. Adherence to guideline-based care will improve patient outcomes by detecting the onset of metabolic syndrome earlier in the disease course. Early monitoring for metabolic changes will improve the health of patients diagnosed with a mental illness.