Depression care effort brings dramatic drop in large HMO population's suicide rate.
atypical antipsychotic and 15 000 children taking albuterol but no antipsychotic drugs. Patients with diabetes were excluded from both groups. The study found that glucose screening was low in both groups, with 31.6% of the patients taking antipsychotics receiving such screening compared with 12.6% of controls. Only 13.4% of the patients treated with antipsychotic drugs received lipid testing compared with 3.1% of controls. Further analysis revealed that children with multiple psychiatric diagnoses and those who used more medical services were most likely to be screened. The results suggest that many physicians are falling short of the level of monitoring recommended in a 2004 consensus statement from several professional groups, including the American Psychiatric Association and the American Diabetes Association. Morrato said that clinicians treating pediatric patients, often primary care physicians, may be less aware of these guidelines, which apply to all age groups, and that there may also be systemic barriers to screening. Correll called for even more aggressive monitoring for metabolic changes in pediatric patients taking atypical antipsychotics than that recommended in 2004. He said that physicians should monitor these patients’ weight and height at each visit, and should do a fasting glucose test when initiating therapy, 3 months later, and every 6 months thereafter. “We are between a rock and a hard place because these children and adolescents are brought to us because they are severely ill,” he said. “They can’t function, so we need to give them effective medications, but we also need to make sure they have the least possible side effects. For that, monitoring and management of these abnormalities is crucial.”