Point-of-Care Testing (POCT) Detection and Management of Metabolic Syndrome in Patients With Mental Illness
Condition: Hyperlipidemia; Diabetes; Hypertension
MeSH terms: Hypertension; Metabolic Syndrome; Hyperlipidemias; Hyperlipoproteinemias
Study type: Interventional

Summary: 
      The study was a 12-month, multi-centered, quasi-experimental design to assess point-of-care
      (POCT) screening/monitoring of subjects on antipsychotic agents for metabolic syndrome.
      Subjects were also randomized to either an Extended Treatment Group (ETG) defined by
      receiving comprehensive medication management (CMM) pharmacist interventions or a Usual
      Treatment Group (UTG) receiving no CMM interventions. All subjects were recruited from three
      community mental health clinic settings in Minnesota.
    

Detailed description: 
      It is well recognized that patients on antipsychotic agents with mental illness continue to
      be affected by a severe health disparity due to lack of adequate metabolic monitoring.1-7 A
      major healthcare concern is the life-expectancy decrease of ~25 years for patients with
      illnesses such as schizophrenia as compared with the general population. Equally concerning
      is that patients with severe persistent mental illness (SPMI) continue to have inadequate
      integration of care between psychiatry and medicine. Because of the difficulty getting
      patients to primary care or hospital based laboratories, the use of capillary blood,
      point-of-care tests (POCT) to monitor glucose and lipids in addition to vital signs and other
      anthropometric measurements in community mental health centers might prove beneficial. It is
      highly likely that this advanced level of screening in the mental health setting may lead to
      identifying new metabolic abnormalities or improved treatment with careful monitoring of
      previously diagnosed metabolic syndrome, diabetes, and/or hypertension in antipsychotic
      treated patients. It is hypothesized that if metabolic abnormalities are identified; then
      providing pharmacist CMM consultative services would reduce medication related problems by
      improving medication adherence, coordination of care between psychiatry and primary care, and
      outcomes in metabolic indices.
    

Intervention name(s): Glucose and lipids; Glycosylated Hemoglobin A1c; Blood Pressure and Heart Rate; Body mass index; Waist and Hip circumference; Comprehensive Medication Management
Intervention type(s): Device; Device; Device; Device; Device; Behavioral
Intervention description(s): Point-of-care (POCT) screening for diabetes and dyslipidemia.
Glucose and Lipids; Point-of-care (POCT) screening for diabetes
Glycosylated Hemoglobin A1c; Point-of-care (POCT) screening for hypertension
Blood Pressure and Heart Rate; Height and weight measurement used to calculate BMI = Mass(kg)/(height (m))squared; Measurement for Central Obesity
Waist and Hip circumference; Defined at http://www.pcpcc.org/guide/patient-health-through-medication-management
Other intervention name(s): Cholestech LDX ® by Inverness Medical www.cholestech.com; A1c Now® by Bayer HealthCare; Omron ® Ultra Premium blood pressure monitor Model HEM-790IT; HealthOMeter® 500KL; QM2000 Circumference measuring tape; CMM, Medication Therapy Management, MTM
Intervention MeSH terms: Chrysarobin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: Metabolic Syndrome; Antipsychotics; Schizophrenia; Bipolar Disorder; Diabetes; Dyslipidemia; Hyperlipidemia; Hypertension; Obesity; Medication Therapy Management; MTM; Pharmacist; Comprehensive Medication Management; CMM; Health Disparity; Monitoring; Point of Care Testing; Chronic Persistent Mental Illness