Metabolic Risk Factors Among Medicaid Outpatients With Schizophrenia Receiving Second-Generation Antipsychotics

Abstract

Schizophrenia is associated with significant reductions in life expectancy, largely because of the increased incidence of cardiovascular disease. This study examined the prevalence of metabolic risk factors for cardiovascular disease among Medicaid recipients diagnosed as having schizophrenia and taking second-generation antipsychotics (medications associated with increased risk of metabolic abnormalities contributing to cardiovascular disease). Fifteen community health centers in King County, Washington, identified 1,317 eligible individuals, of whom 819 completed screenings for obesity, impaired fasting glucose levels or diabetes, hypertension, and dyslipidemia. Fasting serum levels were obtained for 675 individuals, of whom 90% were diagnosed as having at least one risk factor, with elevated body mass index and dyslipidemia the most prevalent factors. About one-third of the individuals approached to participate did not obtain laboratory work necessary for the screening. The study indicates that this population has a high rate of metabolic risk of cardiovascular disease and that treatment will require addressing barriers to screening.