Enhancing metabolic monitoring for children and adolescents using second-generation antipsychotics

2017 ◽  
Vol 27 (3) ◽  
pp. 1188-1198 ◽  
Author(s):  
Mary Coughlin ◽  
Catherine L. Goldie ◽  
Deborah Tregunno ◽  
Joan Tranmer ◽  
Marina Kanellos-Sutton ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Second Generation ◽  
Metabolic Monitoring ◽  
Second Generation Antipsychotics

scholarly journals Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics

2018 ◽  
Vol 63 (4) ◽  
pp. 240-249 ◽  
Author(s):  
Mary Coughlin ◽  
Catherine Lindsay Goldie ◽  
Joan Tranmer ◽  
Sarosh Khalid-Khan ◽  
Deborah Tregunno
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Children And Adolescents ◽  
Second Generation ◽  
Retrospective Chart Review ◽  
Patient Treatment ◽  
Care Utilization ◽  
Metabolic Monitoring ◽  
Second Generation Antipsychotics ◽  
Outpatient Psychiatry

Objective: Children and adolescents with a range of psychiatric disorders are increasingly being prescribed atypical or second-generation antipsychotics (SGAs). While SGAs are effective at treating conduct and behavioural symptoms, they infer significant cardiometabolic risk. This study aims to explore what patient, treatment, and health care utilization variables are associated with adherence to Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) metabolic monitoring guidelines. Method: A retrospective chart review of 294 children and adolescents accessing a large outpatient psychiatry setting within a 2-year study period (2014-2016) was conducted. Baseline and follow-up metabolic monitoring, demographic, treatment, and health care utilization variables were then assessed over a 1-year period of interest. Results: Metabolic monitoring practices did not adhere to CAMESA guidelines and were very poor over the 1-year observation period. There were significant differences between children (ages 4-12 years, n = 99) and adolescents (ages 13-18 years, n = 195). In adolescents, factors associated with any baseline metabolic monitoring were a higher number of psychiatry visits (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.10 to 1.41), longer duration of contact (OR, 14; 95% CI, 2.31 to 82.4), and use of other non-SGA medications (OR, 3.2; 95% CI, 1.17 to 8.94). Among children, having an emergency room visit (OR, 3.4; 95% CI, 1.01 to 11.71) and taking aripiprazole (OR, 7.4; 95% CI, 2.02 to 27.45) increased the odds of receiving baseline metabolic monitoring. Conclusion: Findings from this study highlight the need for better metabolic monitoring for children and adolescents taking SGAs. Enhanced focus on opportunities for multidisciplinary collaboration is needed to improve the quality of care offered to this population.

Monitoring and Treatment of Weight Gain in Children and Adolescents Treated with Second Generation Antipsychotics (SGAs)

2011 ◽  
Vol 1 (1) ◽  
pp. 3-5
Author(s):  
Shannon N. Saldaña ◽  
Jaclyn Kawsky
Keyword(s):  
Insulin Resistance ◽  
Weight Gain ◽  
Children And Adolescents ◽  
Second Generation ◽  
Adverse Outcomes ◽  
Metabolic Effects ◽  
Psychiatric Illnesses ◽  
Metabolic Monitoring ◽  
Second Generation Antipsychotics

ABSTRACT The use of second generation antipsychotics (SGAs) for the treatment of psychiatric illnesses in children and adolescents is increasing. Adverse effects of SGAs include weight gain, dyslipidemia, insulin resistance, and glucose intolerance that can subsequently progress to diabetes. Data suggest that the metabolic effects of SGAs may be more severe in children and adolescents than in adults. The mechanism of SGA-related weight gain is not fully understood and almost certainly due to a combination of factors. A vital first step to minimize risk and long-term adverse outcomes from SGA treatment is to implement consistent metabolic monitoring.

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