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Brief Reports   |    
Primary Care Providers’ Views on Metabolic Monitoring of Outpatients Taking Antipsychotic Medication
Christina Mangurian, M.D.; Funmi Giwa, B.A.; Martha Shumway, Ph.D.; Elena Fuentes-Afflick, M.D., M.P.H.; Eliseo J. Pérez-Stable, M.D.; James W. Dilley, M.D.; Dean Schillinger, M.D.
Psychiatric Services 2013; doi: 10.1176/appi.ps.002542012
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Dr. Mangurian, Ms. Giwa, Dr. Shumway, and Dr. Dilley are affiliated with San Francisco General Hospital (SFGH) and the Department of Psychiatry, University of California, San Francisco (UCSF). Dr. Fuentes-Afflick is with the Department of Pediatrics and the Department of Epidemiology and Biostatistics, UCSF. Dr. Pérez-Stable is with the Division of General Internal Medicine, Department of Medicine, UCSF. Dr. Schillinger is with the UCSF Division of General Internal Medicine at SFGH. Send correspondence to Dr. Mangurian, Department of Psychiatry, University of California, San Francisco, 1001 Potrero Ave., Suite 7M, San Francisco, CA 94110 (e-mail: christina.mangurian@ucsf.edu).

Copyright © 2013 by the American Psychiatric Association


Objective  The purpose of this study was to evaluate attitudes of primary care providers toward barriers to metabolic monitoring and to characterize their beliefs about providers’ responsibility for monitoring and reducing cardiovascular risk for people with severe mental illness.

Methods  An anonymous survey was administered to 214 primary care providers working in 23 public community health clinics in San Francisco.

Results  The response rate was 77% (164 of 214). Nearly 40% of primary care providers were unaware of consensus guidelines for metabolic monitoring of people who take second-generation antipsychotic medications. Responses showed variation in providers’ beliefs about who should monitor patients’ metabolic risk. The major barriers to metabolic monitoring were severity of psychiatric illness, difficulty collaborating with psychiatrists, and difficulty arranging psychiatric follow-up.

Conclusions  Primary care providers believed that better communication between primary care providers and psychiatrists would facilitate metabolic monitoring and promote better treatment for patients with severe mental illness who are taking antipsychotic medications.

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Table 1Barriers to metabolic screening of people with severe mental illnessa
Table Footer Note

a According to 5% or more of 148 primary care providers surveyed



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