The Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM) HEDIS measure, developed in 2015, calculates the percentage of children ages 1–17 who have had two or more antipsychotic prescriptions filled, at least one metabolic test for blood glucose HbA1c, and at least one test for low-density lipoprotein cholesterol (LCL-C) or total cholesterol each year. Examples of first and second-generation antipsychotic medications included in this measure are chlorpromazine, aripiprazole, clozapine, olanzapine, risperidone, haloperidol, and trifluoperazine.
While antipsychotic medications are effective in treating certain mental illnesses in children, their side effects can lead to or exacerbate other health problems. Children taking antipsychotics are prone to significant weight gain and obesity-related complications such as cardiovascular issues, hypertension, hypercholesterolemia, and insulin-resistant type 2 diabetes. Consequently, it is important that patients on antipsychotic medication have annual metabolic testing.
Twice a year, Harvard Pilgrim sends registries to pediatricians and prescribers, listing their patients ages 1-17 who have had two or more antipsychotic prescriptions filled and are missing a cholesterol and/or blood glucose test in the calendar year. Sending this biannual metabolic monitoring report is a fundamental ongoing initiative of Harvard Pilgrim’s Patient Safety Program, and the next mailing will occur in June. For more information about this Harvard Pilgrim initiative, contact the Clinical Programs Department at 800-287-9793 (option 1).