Metabolic Monitoring of Patients Taking Antipsychotics

Second-generation antipsychotics (SGAs) can cause metabolic side effects that result in metabolic syndrome (MetS), which reduces overall life expectancy. Metabolic Syndrome can be mitigated through appropriate monitoring per American Diabetes Association (ADA)/American Psychiatric Association (APA) guidelines. This evidence-based practice (EBP) project aimed to address this problem by improving knowledge of established metabolic monitoring guidelines. Azjen’s Theory of Planned Behavior was the foundation of this project, and implementation was guided by The Rosswurm and Larabee Model for Change. The objective was to increase the metabolic monitoring rate (specifically weight collection at baseline, four weeks, and eight weeks) of patients prescribed SGAs in an outpatient mental health clinic in Phoenix. IRB exemption received from ASU. Participants included all staff members in the clinic. Participants (n=5) completed a pre/post-intervention survey. In addition, providers (n=2) completed the Metabolic-Barriers, Attitudes, Confidence, and Knowledge (M-BACK) questionnaire pre- and post-intervention to assess knowledge regarding metabolic monitoring. De-identified aggregate data collection was used retrospectively to determine the initial metabolic monitoring rate and then again to determine the post-intervention metabolic monitoring rate to assess the effectiveness of the educational intervention. Scores on the knowledge survey and M-BACK increased post-intervention. The metabolic monitoring rate increased post-intervention. Metabolic monitoring rates improve when staff have adequate knowledge of metabolic monitoring guidelines.