Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Impact of patients' preexisting metabolic risk factors on the choice of antipsychotics by office-based physicians.

Li C, Mittal D, Owen RR. Impact of patients' preexisting metabolic risk factors on the choice of antipsychotics by office-based physicians. Psychiatric services (Washington, D.C.). 2011 Dec 1; 62(12):1477-84.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

OBJECTIVE: This study examined the association between patients' preexisting metabolic risk factors and the physician's choice of antipsychotic agent based on its propensity to cause metabolic side effects. METHODS: Data were from the 2005-2007 National Ambulatory Medical Care Survey (NAMCS); 1,898 office-based visits were identified during which prescriptions of antipsychotics were mentioned. Antipsychotics were classified as having high, medium, or low risk based on their propensity to cause metabolic abnormalities; a separate category for antipsychotic polypharmacy was specified for visits during which multiple antipsychotics were mentioned. Patients' preexisting metabolic risk was assessed by the presence of diabetes, hyperlipidemia, obesity, or hypertension. With controls for other patient and physician characteristics, multinomial logit regression models were applied to examine the association between the level of metabolic risk of the prescribed antipsychotic agents and the patient's baseline metabolic risk. RESULTS: Compared with patients of normal weight or who were underweight according to body mass index, obese patients were less likely to receive antipsychotics with high risk (relative risk ratio [RRR] = .14, 95% confidence interval [CI] = .05-.37) or medium risk (RRR = .39, CI = .19-.78) of causing metabolic abnormalities. However, having preexisting metabolic conditions, such as diabetes, hyperlipidemia, or hypertension, had little effect on physicians' choice of antipsychotics with regard to metabolic risk properties. CONCLUSIONS: Patients' weight appeared to be the key consideration in providers' decision to order or continue antipsychotics according to the associated metabolic risk. Further studies are warranted to understand the factors that determine the choice of antipsychotics for patients with preexisting metabolic conditions, such as diabetes, hyperlipidemia, or hypertension.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.