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Member Research and Reports

Member Research and Reports

Colorado Research: Lipid Testing Underutilized in Mentally Ill Patients

According to new research from the Colorado School of Public Health, too few adults taking antipsychotic medications are being screened for abnormalities in lipids, which include cholesterol and triglycerides.

Dr. Elaine Morrato
[Photo: Dr. Elaine Morrato]

The most significant gap in screening, among adults ages 40 and below, is the same group for whom early detection and intervention has been shown to be effective when cardiovascular risk is present.

Dr. Elaine Morrato, lead author of the study, says antipsychotic medications are associated with substantial weight gain, as well as changes in insulin sensitivity and lipid metabolism, which increase the risk of diabetes and cardiovascular disease. This poses greater issues as individuals with serious mental illnesses are also more prone to high cholesterol, high blood pressure, heart disease, and diabetes.

Compared to prior studies, progress has been made in improving diabetes screening, however, lipid screening remains especially underutilized. This report, published in JAMA Psychiatry, included over 9,000 Missouri Medicaid patients that identified factors linked with failure to receive glucose and lipid testing during treatment using antipsychotics.

Another notable finding was that about 75 percent of patients initiated therapy with a prescriber not practicing in a community mental health center, and about half initiated therapy with a non-behavioral health care professional.

Failure to receive testing was most strongly associated with patient characteristics and factors affecting frequency of health care utilization. One possible reason of such low testing may be due to conflicting information about whether young adults should be tested. On a national level, guidelines for screening range widely.

Better integration of behavioral health and primary care services is a public health priority. More research on the effectiveness of metabolic screening for younger adults receiving antipsychotics is needed to resolve the ambiguity in screening guidelines.

Read more, here.