Glucose monitoring in new users of second-generation antipsychotics in older people |
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| Affiliation: | 1. Department of Psychiatry, University of Leipzig, Leipzig, Germany;2. Max Planck Institute of Psychiatry, Munich, Germany;3. Lilly Deutschland GmbH, Medical Department, Bad Homburg, Germany;4. Department of Child and Adolescent Psychiatry, Central Institute of Mental Health Mannheim, University of Heidelberg, Germany;5. Fachklinik St. Marienstift, Center for Psychiatric and Psychotherapeutic Treatment for Traumatized Males, Neuenkirchen, Germany;6. Frankenalb-Klinik, District Hospital of Psychiatry, Psychotherapy, Psychosomatics and Addiction Rehabilitation, Engelthal, Germany;7. Klinikum Ingolstadt, Center of Mental Health, Ingolstadt, Germany;1. Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK;2. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King''s College London, UK;3. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King''s College London, UK;1. The National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & Peking University Institute of Mental Health & The Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China;2. The National Clinical Research Center for Mental Disorders (Beijing Anding Hospital) & Department of Psychiatry, Capital Medical University & Center of Depression, Beijing Institute for Brain Disorders, China;3. Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, China;4. Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA;5. School of Psychiatry & Clinical Neuroscience, University of Western Australia, Perth, Australia;6. Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China;7. Psychiatric Hospital, Guangzhou, China;8. Department of Psychiatry, Renmin Hospital, Wuhan University, Wuhan, China;9. The First Hospital of Shanxi Medical University, Shanxi Province, China;10. West China Hospital, Sichuan University, China;11. Neuropsychiatric Hospital, Jilin, China;12. Mental Health Center, Xi-an, China;13. Jiangxi Psychiatric Hospital, Jiangxi, China;14. Suzhou Guangji Hospital, Suzhou, China;15. Hebei Mental Health Center, Hebei, China |
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| Abstract: | ObjectiveTreatment guidelines published world-wide have highlighted concerns of increased metabolic risks associated with second-generation antipsychotics (SGAs).The aim of the study was to evaluate blood glucose monitoring rates for SGA new users in older people aged 65 years and above during the study period 2006–2012, and investigate the pre-post 2007 Best Practice Advocacy Centre’s (bpacnz) glucose monitoring recommendation in New Zealand.MethodsThe study was a population-based retrospective cohort of SGA new users (365 days without pre-exposure to antipsychotics). Pharmaceutical collections data were extracted and used to identify older people dispensed SGAs and linked to the National Minimum Dataset and Laboratory Claims collection. WHO Methodology’s Anatomical Therapeutic Chemical method’s classification was used to characterise the SGAs dispensed.ResultsOf the 25,603 new users dispensed SGAs, 63.5% received glycaemic control monitoring at least once during the study period. Of these, only 20.1% were monitored at baseline, 38.7% were monitored for glycaemic control within the first 90 days. Glycaemic control monitoring within the first 180 days increased to more than half (57.5%) of the SGA new users. Proportion of individuals monitored were independent (χ2 = 6.1; P = 0.4) of pre-post bpacnz recommendation.ConclusionsBlood glucose monitoring was underutilized in new SGA users. No significant improvement in glycaemic control monitoring was observed after the 2007 bpacnz consensus statement release at baseline, 90 days and at 180 days. Prescribers must be cautioned about the metabolic risks posed by SGAs and recommend glycaemic control monitoring. |
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| Keywords: | Glucose monitoring Glycaemic control Second-generation antipsychotics Older people Guidelines |
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