Primary Care Providers' Views on Metabolic Monitoring of Outpatients Taking Antipsychotic Medication

Objective: The purpose of this study was to evaluate attitudes of primary care providers toward barriers to metabolic monitoring and to characterize their beliefs about providers' responsibility for monitoring and reducing cardiovascular risk for people with severe mental illness. Methods: An anonymous survey was administered to 214 primary care providers working in 23 public community health clinics in San Francisco. Results: The response rate was 77% (164 of 214). Nearly 40% of primary care providers were unaware of consensus guidelines for metabolic monitoring of people who take second-generation antipsychotic medications. Responses showed variation in providers' beliefs about who should monitor patients' metabolic risk. The major barriers to metabolic monitoring were severity of psychiatric illness, difficulty collaborating with psychiatrists, and difficulty arranging psychiatric follow-up. Conclusions: Primary care providers believed that better communication between primary care providers and psychiatrists would facilitate metabolic monitoring and promote better treatment for patients with severe mental illness who are taking antipsychotic medications.