BY MARK MORAN
Seven cutting edge researchers presented original research relevant to psychiatry and psychiatric patients at a special presentation chaired by Jeffrey Borenstein, M.D., editor of Psychiatric News. Ronit Kedem Dedesma, M.D., consultation-liaison psychiatrist at Cambridge Health Alliance and instructor at Harvard Medical School, discussed her research on, “Using an Electronic Medical Record to Improve Monitoring for Patients on Antipsychotic Medicines.” Dr. Dedesma said patients with serious mental illness (SMI) are less likely to receive adequate management of diabetes, high cholesterol, and heart disease, and noted that antipsychotic medications used to treat SMI increase the risk of diabetes and other health problems.
She described an effort at Cambridge Health Alliance to use electronic medical records (EMR) to provide education and reminders about the need to monitor for metabolic status in patients with SMI for clinicians in family medicine, internal medicine, and psychiatry. However, between 2010 and 2011, there was no significant difference in clinician behavior with regard to monitoring metabolic status, suggesting the need to further refine efforts. “Rates of monitoring patients on antipsychotics for metabolic parameters is suboptimal and our interventions have not yet been effective,” she said. “We are working to implement more EMR tools and systems changes to increase awareness and follow through.”
Peter J. Neumann, Sc.D., Director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center and Professor of Medicine at Tufts University School of Medicine, talked about his research looking at “The Hidden Costs of Attention Deficit/Hyperactivity Disorder.” He found that while the magnitude of estimates varies widely – with incremental costs of ADHD ranging between $101 – $163 billion – overall the analysis indicates that ADHD is associated with a substantial individual and societal economic impact. Dr. Neumann said the major cost drivers are work-related costs: income losses due to lower wages and unemployment and education-related costs. “Results indicate need for policies that incentivize third-party payers to consider all cost sectors when evaluating cost-effectiveness of coverage and ADHD treatments,” he said.
Umesh Vyas, M.D., Chair of the Department of Psychiatry and Medical Director of the Behavioral Health Unit and Medical Director of Sleep Disorders Center, Mayo Clinic Health System, described his research on “Treating Sleep Disorders has Positive Outcomes in Psychiatric Illness.”
He performed a review of electronic medical records for diagnosis of sleep disorders at Clement J. Zablocki VA Medical Center in Milwaukee from October 2007 to December 2007. Patients with confirmed diagnosis and treatment for sleep disorders were included and outcomes in patients with comorbid psychiatric disorders were recorded at 6, 12 and 24 months after initiation of sleep disorder treatment.
He found that treatment of comorbid sleep disorders was associated with significant improvement in psychiatric disorders and that psychiatric disorders did not affect compliance with sleep disorders treatment. Dr. Vyas noted that there is a strong need for prospective studies with more subjects.
Other presenters included Abid Malik, M.D., Medical Director at the Sleep Disorder Center, South Seminole Hospital of Orlando Health; David Tran, a medical student at David Geffen School of Medicine at UCLA; Janet Williams, Ph.D., Vice President of Clinical Development, MedAvante, Inc.; and Dinesh Mittal, M.D., Associate Professor, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences.