Cardiovascular risk factor measurement patterns in patients with severe mental illness receiving comprehensive medication management pharmacist care.

BACKGROUND: Individuals with severe mental illness (SMI) are more likely to die from cardiovascular disease (CVD) than those without SMI, yet screening for CVD risk factors is often inadequate. Comprehensive medication management (CMM) pharmacists help to address the complex healthcare needs of individuals with SMI and may enhance rates of CVD screening. OBJECTIVE: This study describes rates of screening for CVD risk factors among patients with SMI prescribed antipsychotic medication who received CMM pharmacist care within a large health system. METHODS: This retrospective study of SMI patients treated by CMM pharmacists examined screening for four common CVD risk factors at and 90-days following initial CMM visit. Health system utilization and medication therapy problems (MTPs) were compared using chi squared tests based on baseline completion of all four CVD risk factors. RESULTS: Of 1455 patients with SMI prescribed antipsychotic medication seen by CMM pharmacists, 65.1% had complete measurements for blood pressure, body mass index, blood glucose, and low-density lipoprotein cholesterol at baseline, and approximately one-third (N=186) of patients with at least one missing measurement at baseline had complete measurements within 90 days. CMM pharmacists identified 1932 MTPs at patients' first CMM visits. Adherence problems-often due to misunderstanding instructions or forgetting to take medications-were identified (N=391, 20.2%), and nearly 90% of CMM pharmacist interventions offered to address these issues were accepted by patients and other providers. CONCLUSION: CMM pharmacists have opportunities to address gaps in care, particularly with increasing screening rates for CVD risk factors and identifying MTPs.