0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Research Letter |

Diabetes Screening Among Underserved Adults With Severe Mental Illness Who Take Antipsychotic Medications

Christina Mangurian, MD1,2; John W. Newcomer, MD3; Eric Vittinghoff, PhD4; Jennifer M. Creasman, MSPH5; Penelope Knapp, MD6; Elena Fuentes-Afflick, MD, MPH4,7; Dean Schillinger, MD2,8
[+] Author Affiliations
1Department of Psychiatry, University of California, San Francisco
2Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, University of California, San Francisco
3Department of Integrated Medical Science, The Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton
4Department of Epidemiology and Biostatistics, University of California, San Francisco
5Department of Obstetrics and Gynecology, University of California, San Francisco
6Department of Psychiatry and Behavioral Sciences, University of California, Davis
7Department of Pediatrics, University of California, San Francisco
8Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2015;175(12):1977-1979. doi:10.1001/jamainternmed.2015.6098.
Text Size: A A A
Published online

Extract

This retrospective cohort study analyzes diabetes screening prevalence and predictors of screening among adults in the California public mental health care system with severe mental illness taking antipsychotic medications.

Adults in the United States with severe mental illness (SMI), such as schizophrenia and bipolar disorder (totaling approximately 7 million), are estimated to die, on average, 25 years earlier than the general population, largely of premature cardiovascular disease.1 The Institute of Medicine2 has called for improvements in health care for this population. Severe mental illness is associated with elevated risk for type 2 diabetes mellitus.3 Treatment with antipsychotic medications contributes to risk, with most evidence focused on second-generation antipsychotic medications, but similar increases in risk are reported with older and newer medications.4 The American Diabetes Association5 recommends annual diabetes screening for patients treated with antipsychotic medications, and public health administrators have targeted this population for improved health screening.6 To our knowledge, no studies have examined screening rates in this highest-risk population of adults with SMI because of limitations in public health medical records. We examined diabetes screening among publicly insured adults with SMI taking antipsychotic medications using matched administrative data for physical and mental health care services in a large health care system. We measured diabetes screening prevalence among patients with SMI treated with antipsychotic medications and assessed characteristics predictive of screening.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

1,229 Views
2 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Diabetes, Foot Ulcer

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Diabetic Peripheral Neuropathy

brightcove.createExperiences();