Evidence-Based Interventions to Increase Cardiometabolic Screening Rates in Psychiatric Patients

Abstract

Purpose: The purpose of this quality improvement project is to increase provider knowledge about evidence-based interventions to increase cardiometabolic screening rates for patients being prescribed psychotropic medication in an outpatient behavioral health setting.Background: Psychiatric patients face high rates of comorbid medical conditions that can decrease their life expectancy by 10 to 20 years when compared to the general population. Patients who have serious and/or severe mental illness (SMI) are at particularly elevated risk of developing medical illness. Medical comorbidities in this population often begin with cardiometabolic changes manifesting as obesity and high BMI, increased blood pressure, increased glucose, and increased lipids, commonly referred to as metabolic syndrome (MetS). These cardiometabolic changes are precursors to diabetes (DM) and cardiovascular disease (CVD), two leading causes of death in the United States (US), contributing to a mortality rate that is two to four times higher than those without psychiatric illness. Methods: Model for Improvement was the design used for this quality improvement project. Participants were recruited via email to a web-based educational presentation educating them about evidence-based interventions to increase cardiometabolic screening rates in patients who take psychotropic medications. Participants completed pretest and posttest surveys to measure changes in provider knowledge of cardiometabolic screening recommendations for patients who take psychotropic medications, the perceived benefit of implementing screening of patients taking psychotropic medications, and intent to adopt cardiometabolic screening in practice. Results: Median scores increased in the third question concerning intent to adopt cardiometabolic screenings in their practice. The first and second questions related to perceived knowledge of cardiometabolic screening recommendations and the benefit of screening had no change in median scores. Additionally, providers identified perceived facilitators such as reminders, communication, templates, and internal labs and perceived barriers such as patient noncompliance, telehealth services, system issues, and the cost of a healthy diet in having their screenings completed. Conclusion: The educational intervention yielded anticipated outcomes. Results show an increase in provider intent to ensure cardiometabolic screening of patients who take psychotropic medications in their practice.