RT Journal
A1 Morrato EH, Nicol GE, Maahs D, et al
T1 MEtabolic screening in children receiving antipsychotic drug treatment
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD April 1
VO 164
IS 4
SP 344
OP 351
DO 10.1001/archpediatrics.2010.48
UL http://dx.doi.org/10.1001/archpediatrics.2010.48
AB Objectives 
    To estimate metabolic screening rates, predictors of screening, and incidence of metabolic disturbances in children initiating second-generation antipsychotic (SGA) drug treatment.Design 
    A retrospective, new-user cohort study (between July 1, 2004, and June 30, 2006) using Medicaid claims data.Settings 
    California, Missouri, and Oregon.Patients 
    A total of 5370 children (aged 6-17 years) without diabetes mellitus taking SGA drugs and 15 000 children without diabetes taking albuterol (control) but no SGA drugs.Intervention 
    Findings 1 year after recommendations from the American Diabetes Association and American Psychiatric Association called for metabolic screening of patients receiving SGA drugs.Outcome Measures 
    Serum glucose and lipid testing, 6-month incidence of diabetes, and dyslipidemia disturbances.Results 
    Glucose screening was performed in 1699 (31.6% [95% confidence interval (CI), 30.4%-32.9%]) SGA-treated children vs 1891 (12.6% [12.1%-13.2%]) control individuals. Lipid testing was performed in 720 (13.4% [95% CI, 12.5%-14.4%]) SGA-treated children vs 458 (3.1% [2.8%-3.3%]) controls. In multivariate logistic regression analysis, children with serious and/or multiple psychiatric diagnoses and those who used health care services more intensively were more likely to receive metabolic screening. The case incidence of glucose and lipid disorders was higher in SGA-treated vs albuterol-treated children (8.9 per 1000 children [95% CI, 6.6%-11.8%] vs 4.9 per 1000 children [3.9%-6.2%]; and 9.7 per 1000 children [95% CI, 7.2%-12.7%] vs 4.6 per 1000 children [95% CI, 3.6%-5.8%], respectively).Conclusion 
    Most children starting treatment with SGA medications in this public sector sample did not receive recommended glucose and lipid screening.