Students Research in Progress
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction: Recent data indicates that approximately 35.6% of children receiving atypical antipsychotic (AAP) pharmacotherapy receive appropriate guideline-directed cardiometabolic monitoring. This study aims to assess the effectiveness of a pharmacist-led monitoring service towards improving monitoring adherence within a large primary care clinic for children with medical complexity.
Research Question or Hypothesis: Adherence to AAP monitoring guidelines will improve following the initiation of a pharmacist-led service within a pediatric complex care clinic.
Study Design: Single-center, retrospective quality improvement study.
Methods: Clinic patients receiving AAP therapy from 7/2022-6/2023 were eligible for inclusion. Patients were excluded if: duration of AAP use was <2 months, discontinuation occurred prior to the due date of annual monitoring, use occurred exclusively on an as-needed basis, or EHR data was incomplete. Monitoring data was collected for the period spanning 12 months pre-service implementation to 12 months post-implementation (7/2021-6/2023). Collected data included demographic information, dates of AAP initiation and collection of relevant blood work (i.e., CMP, HbA1c/glucose, lipid panel, CBC, prolactin, TSH), and documentation of abnormal findings. Dates of use and monitoring were assessed to determine adherence to baseline and routine guideline monitoring recommendations: cardiometabolic adherence was defined as measurement of HbA1c/glucose and lipid panel within the applicable period; full adherence required measurement of all recommended labs. Demographic information was analyzed using descriptive statistics; pre/post-intervention categorical data was analyzed using the McNemar test.
Results: A total of 213 patients were eligible for inclusion. Analysis included 191 patients following application of exclusion criteria. The majority were male (61.8%) and publicly insured (69.6%). Pharmacist-directed monitoring was performed for 84% of patients; guideline-adherent lab monitoring was recommended for 79% of patients receiving the service. Cardiometabolic monitoring adherence improved from 40.4% to 79.6% following implementation (p<0.001). Full monitoring adherence increased from 29.8% to 70.6% (p<0.001).
Conclusion: Results demonstrate that a pharmacist-led monitoring service significantly improved adherence to guideline-recommended monitoring for patients receiving AAP pharmacotherapy.
Presenting Author
Berkley Peiker BSUniversity of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences
Authors
Lucas Orth PharmD
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO