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Table 2 Measures of screening for cardiovascular risk factors in persons with serious mental illness, 2000-2013

From: Screening for cardiovascular risk factors in adults with serious mental illness: a review of the evidence

Study population Main finding in words References
Panel 1: Screening for Overweight and Obesity
Body Mass Index
N: 40600 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Outpatient Veterans participating in the National Psychosis Registry, | Screening year(s): 2007 | Time window for ascertaining screening rate: Bi-annual | Data source: Administrative claims 76% of patients had Body Mass Index (BMI) assessed in 2007 Kilbourne, 2011 [22]
Panel 2: Screening for Diabetes Mellitus
Glucose screening
N: 55436 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and Outpatient Medicaid beneficiaries from California, Oregon, Tennessee and Utah | Screening year(s): 1998–2003 | Time window for ascertaining screening rate: 14 days prior-28 days after second generation antipsychotic initiation | Data source: Administrative claims 18% of those without schizophrenia and 23% of those with schizophrenia had a glucose test during 1998-2003 Morrato, 2008 [25]
Compared to those without schizophrenia, those with schizophrenia had 1.5 times greater odds of having a glucose test during 1998–2003 (p < .05)
N: 18876 | % of study sample with schizophrenia or bipolar disorder: 3.4% schizophrenia and 49.3% mood disorders, including bipolar disorder | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient commercial health insurance beneficiaries | Screening year(s): 2001–2006 | Time window for ascertaining screening rate: 30 days prior-30 days after second generation antipsychotic initiation | Data source: Administrative claims The mean glucose testing rate for antipsychotic-treated patients was 23% during 2001-2006 Morrato, 2009 [27]
N: 2204 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Kansas Medicaid beneficiaries | Screening year(s): 2003 | Time window for ascertaining screening rate: Annual | Data source: Administrative claims 23% of patients had a glucose test during 2002-2003 Moeller, 2011 [26]
29% of patients with dyslipidemia had a glucose test during 2002-2003
N: 1646| % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Kansas Medicaid beneficiaries| Screening year(s): 2005-2007| Time window for ascertaining screening rate: Annual | Data source: Administrative claims 75% of patients had a glucose test during 2005-2007
65% of patients with dyslipidemia had a glucose test during 2005-2007
N: 6601 | % of study sample with schizophrenia or bipolar disorder: Not reported | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient California Medicaid recipients | Screening year(s): 2004-2005| Time window for ascertaining screening rate: Six months prior to-6 months after second generation antipsychotic initiation| Data source: Administrative claims 24% of patients had a glucose test in the six months prior to antipsychotic initiation during 2004-2005 Barnett, 2010 [32]
28% of patients had a glucose test in the six months after antipsychotic initiation during 2004-2005
N: 40600 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Outpatient Veterans participating in the National Psychosis Registry | Screening year(s): 2007 | Time window for ascertaining screening rate: Bi-annual | Data source: Administrative claims 60% of patients had at least two glucose tests in 2007 Kilbourne, 2011 [22]
Glucose and Lipids Screening
N: 6601 | % of study sample with schizophrenia or bipolar disorder: Not reported | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient California Medicaid recipients | Screening year(s): 2004–2005 | Time window for ascertaining screening rate: Six months prior-6 months after second generation antipsychotic initiation| Data source: Administrative claims 23% of patients had both a glucose test and a lipid test in the six months prior to antipsychotic initiation during 2004-2005 Barnett, 2010 [32]
27% of patients had both a glucose test and a lipid test in the six months after antipsychotic initiation during 2004-2005
Panel 3: Screening for Dyslipidemia
Any Lipid Screening
N: 200 | % of study sample with schizophrenia or bipolar disorder: 75% | Percent antipsychotic users: Not reported | Study population: Outpatients from psychiatric care centers in Baltimore, MD | Screening year(s): 2000 | Time window for ascertaining screening rate: Annual| Data source: Interview data In 2000, 51% of patients reported having had their cholesterol checked in the past year Dickerson 2003 [38]
N: 55436 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and Outpatient Medicaid beneficiaries from California, Oregon, Tennessee and Utah | Screening year(s): 1998–2003 | Time window for ascertaining screening rate: 14 days prior-28 days after second generation antipsychotic initiation | Data source: Administrative claims 6% of those without schizophrenia and 9% of those with schizophrenia had a lipid test during 1998-2003 Morrato, 2008 [25]
Compared to those without schizophrenia, those with schizophrenia had 1.4 times greater odds of having a lipid test during 1998–2003 (p < .05)
N: 94 | % of study sample with schizophrenia or bipolar disorder: 100% Percent antipsychotic users: Not reported | Study population: Outpatient homeless shelter clinic users | Screening year(s): 1999–2000 | Time window for ascertaining screening rate: Annual | Data source: Medical chart review 55% of those with schizophrenia had a lipid test during 1999-2000 Folsom, 2002 [35]
N: 408 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Veterans | Screening year(s): 1999–2003 | Time window for ascertaining screening rate: Four years | Data source: Administrative claims 85% of patients had at least one lipid test during 1999-2003 Weissman, 2006 [31]
27% of patients had only one lipid test during 1999-2003
N: 64,490 | % of study sample with schizophrenia or bipolar disorder: 51% mood disorders, including bipolar disorder| Percent antipsychotic users: Not reported | Study population: Outpatient Veterans from New England Health Care System | Screening year(s): 2000–2001 | Time window for ascertaining screening rate: Annual | Data source: Administrative claims 85% of patients with mental illness had a lipid test, compared to 78% of patients without mental illness in 2001 Kaplowitz, 2006 [30]
Compared to those without SMI, those with SMI had 2.73 times greater odds of having a lipid test in 2001 (p < .05)
N: 18876 | % of study sample with schizophrenia or bipolar disorder: 3.4% schizophrenia, 49.3% mood disorders, including bipolar disorder| Percent antipsychotic users: 100% | Study population: Inpatient and outpatient commercial health insurance beneficiaries | Screening year(s): 2001–2006 | Time window for ascertaining screening rate: 30 days prior-30 days after second generation antipsychotic initiation | Data source: Administrative claims The mean lipid testing rate for antipsychotic-treated patients was 8% during 2001-2006 Morrato, 2009 [27]
N: 2204| % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Kansas Medicaid beneficiaries | Screening year(s): 2003| Time window for ascertaining screening rate: Annual | Data source: Administrative claims 10% of patients had a lipid test during 2002-2003 Moeller, 2011 [26]
N: 1646| Diagnoses: Schizophrenia | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Kansas Medicaid beneficiaries | Screening year(s): 2005–2007 | Time window for ascertaining screening rate: Annual | Data source: Administrative claims 53% of patients had a lipid test during 2005-2007
N: 6601 | % of study sample with schizophrenia or bipolar disorder: Not reported| Percent antipsychotic users: 100% | Study population: Inpatient and outpatient California Medicaid recipients | Screening year(s): 2004–2005 | Time window for ascertaining screening rate: Six months prior-6 months after second generation antipsychotic initiation | Data source: Administrative claims 39% of patients had a lipid test in the six months prior to antipsychotic initiation during 2004-2005 Barnett, 2010 [32]
43% of patients had a lipid test in the six months after antipsychotic initiation during 2004-2005
N: 46,430 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: Not reported | Study population: Inpatient or outpatient veterans with hyperlipidemia participating in National Psychosis Registry | Screening year(s): 2005 | Time window for ascertaining screening rate: Annual | Data source: Medical chart review 90% of those with SMI, 94% of those with depression, and 94% of those without a psychiatric disorder had a lipid test in 2005 (p < .001) Kilbourne, 2008 [34]
N: 40600 | % of study sample with schizophrenia or bipolar disorder: 100% |Percent antipsychotic users: 100% | Study population: Outpatient Veterans participating in the National Psychosis Registry| Screening year(s): 2007 | Time window for ascertaining screening rate: Annual | Data source: Administrative claims 37% of patients had a lipid test in 2007 Kilbourne, 2011 [22]
Low Density Lipoprotein (LDL) Screening
N: 408 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Veterans | Screening year(s): 1999–2003 | Time window for ascertaining screening rate: four years| Data source: Administrative claims 74% of patients had at least one LDL test during 1999-2003 Weissman, 2006 [31]
28% of patients had only one LDL test during 1999-2003
Triglyceride Screening
N: 408 | % of study sample with schizophrenia or bipolar disorder: 100% | Percent antipsychotic users: 100% | Study population: Inpatient and outpatient Veterans | Screening year(s): 1999–2003 | Time window for ascertaining screening rate: four years | Data source: Administrative claims 85% of patients had at least one triglycerides test during 1999-2003 Weissman, 2006 [31]
27% of patients had only one triglycerides test during 1999-2003
Panel 4: Screening for Hypertension
Any Blood Pressure Assessment
N: 200 | % of study sample with schizophrenia or bipolar disorder: 75%| Percent antipsychotic users: Not reported | Study population: Outpatients from psychiatric care centers in Baltimore, MD | Screening year(s): 2000 | Time window for ascertaining screening rate: Annual| Data source: Interview data In 2000, 88% of patients reported having had their blood pressure checked in the past year Dickerson 2003 [38]
N: 40600 | % of study sample with schizophrenia or bipolar disorder: 100% |Percent antipsychotic users: 100% | Study population: Outpatient Veterans participating in the National Psychosis Registry | Screening year(s): 2007 | Time window for ascertaining screening rate: Annual | Data source: Administrative claims 79% of patients had blood pressure assessed in 2007 Kilbourne, 2011 [22]