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Purpose: This study sought to assess the change in monitoring rates for second-generation antipsychotics (SGAs) at the Buzz Westfall Justice Center (BWJC) following interventions made by the clinical pharmacist and students. The interventions included development of a protocol outlining recommended monitoring parameters and rates for SGAs and a weekly pharmacy referral clinic for administration of the Abnormal Involuntary Movement Scale (AIMS).
Methods: A retrospective chart review was conducted for BWJC patients receiving SGAs from 12-01-2008 to 5-31-2009. The review identified several categories below facility goal rates of greater than or equal to 80%. The clinical pharmacist and students provided education on the recommended monitoring parameters and frequencies to the mental health providers at BWJC, prepared written instructions for psychiatry residents and instituted a weekly referral clinic for administration of the AIMS. A follow-up review was conducted to collect the monitoring rates from 12-01-2009 to 5-31-2010. Monitoring rates for each parameter post-intervention were compared to the pre-intervention rates using a chi-squared test with a significance level of 0.05. Parameters monitored were body mass index (BMI), fasting plasma glucose (FPG), fasting lipid profile (FLP), AIMS test, liver function tests (LFTs), and complete blood count (CBC).
Results: Overall rates for BMI, AIMS, and LFTs were statistically significantly improved after the pharmacy intervention. Only the rates for BMI improved to above the goal rate. No statistically significant differences were seen in overall rates for FPG, FLP, or CBC.
Conclusions: The initiation of the AIMS clinic has been a positive improvement and will continue to be offered. Potential future changes for improving monitor rates of lab tests include verbal education of all new psychiatry residents by the pharmacist or routine assessment and laboratory ordering by pharmacy for patients taking SGAs.