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Monitoring of Metabolic, Cardiac, and Endocrine Indicators in Youth Treated With Antipsychotics as Reported by Health Care Professionals

Minjon, Lenneke, PharmD*; van den Ban, Els, MD, PhD; de Jong, Emma, BSc*; Egberts, Toine C.G., PhD*‡; Heerdink, Eibert R., PhD*‡§

Journal of Clinical Psychopharmacology: October 2018 - Volume 38 - Issue 5 - p 489–493
doi: 10.1097/JCP.0000000000000936
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Background It is unclear how youth treated with antipsychotics are monitored. The purpose of this study was to assess monitoring of metabolic, cardiac, and endocrine indicators in youth (<18 years old) treated with antipsychotics as reported by health care professionals in the Netherlands.

Methods A questionnaire was designed to collect information from health care professionals regarding the monitoring of youth treated with antipsychotics. Data were collected at a national conference.

Findings and Results Fifty-nine health care professionals completed the questionnaire, of which 53 (89.8%) were child and adolescent psychiatrists (approximately 20% of all child and adolescent psychiatrists in the Netherlands). More than 80% of respondents reported monitoring physical indicators—weight, height, body mass index, heart rate, and blood pressure—and over 50% reported monitoring laboratory indicators—lipid profile, blood glucose, and prolactin level. Most of the respondents reported monitoring physical indicators more than twice per year and laboratory indicators once per year. Almost all respondents (56/59, 94.9%) reported monitoring according to a clinical guideline or protocol. Only 1 respondent reported monitoring the indicators completely according to the clinical guideline. Respondents mentioned that facilitating factors for monitoring, such as access to electrocardiogram facilities, were insufficiently available.

Conclusions Although all health care professionals reported monitoring metabolic, cardiac, and endocrine indicators in youth treated with antipsychotics, great variability exists in reported monitoring practices. Factors contributing to this variability must be assessed to optimize the benefit-risk ratio for the individual patient.

From the *Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht;

Karakter Child and Adolescent Psychiatry, Zwolle;

Department of Clinical Pharmacy, Utrecht University Medical Center, Utrecht; and

§Research Group Innovation of Pharmaceutical Care, University of Applied Sciences, Utrecht, the Netherlands.

Received December 21, 2017; accepted after revision June 29, 2018.

Reprints: Eibert R. Heerdink, PhD, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, P.O. Box 80082, 3508 TB Utrecht, the Netherlands (e-mail: e.r.heerdink@uu.nl).

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