Advocacy for better metabolic monitoring after antipsychotic initiation: based on data from a French health insurance database. Issue 2 (1st February 2021)

• Record Type: Journal Article
• Authors: Bulteau, Samuel; Le Pierres, Marine; Artarit, Pascal; Forestier, Bastien; Michaud, Emmanuelle; Chaslerie, Anicet; Bonnot, Olivier; Victorri-Vigneau, Caroline
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 2(2021)
• Page Start: 225
• Page End: 233
• Publication Date: 2021-02-01
• Subjects: Antipsychotics -- metabolic syndrome -- monitoring -- health insurance database; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1851678
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Background : Nearly 3% of the population is treated by antipsychotic. The aim of this study was to assess the conformity of monitoring with guidelines to prevent Metabolic Syndrome. Research design and method : The analysis was conducted using SNIIRAM data (2013 to 2017) on a cohort of patients who received at least eight antipsychotic dispensings in the first year. Glucose and lipid testings were recorded according to refunds at initiation [between −3 and 0.5 months], 3 months [between 2 and 4 months], and 12 months [between 11 and 13 months] after, and assuming optimal testing during hospitalization (exclusive of psychiatric unit). Descriptive and comparative analysis, «chi-squared test or Student's t-test», were performed as well as multivariate analysis with logistic regression. Results : 18 760 patients were selected, 14 421 were still alive and monitored at the end of the follow up. In the recommended period, only 2.89% of patients had three complete testings and 50.6% one or two complete testings Non-optimal testing was more likely to occur in children and adults (vs elderly), in patients with less than 3 prescribers, and with universal medical coverage. Conclusion : Monitoring remains dramatically insufficient. New actions involving patients, practitioners, and authorities are warranted.