Screening SSRI-users for diabetes in a general practice

摘要

Purpose - A pragmatic evaluation of the practicality of diabetes screening for users of serotonin specific reuptake inhibitors (SSRI's). The paper aims to discuss this issue. Design/methodology/approach - This study audited the response of SSRI-users to personal invitation for diabetes screening. One-third of such patients had been screened during the past year. The remaining 217 patients were invited for fasting blood glucose tests and the improvement in screening rates measured. The rate of positive results was compared to a cohort who received fasting blood glucose screening due to physical risk factors for diabetes. Findings - Specific invitation increased the take-up of screening from 34 to 52 per cent of SSRI-users. Engagement was significantly better when patients could be contacted by telephone rather than letter. The SSRI-using cohort had a greater rate of identified diabetes than a cohort with physical risk factors for diabetes. Practical implications - SSRI-users are a difficult group to engage in medical screening and an assertive approach is of value. It is likely that the physical care of these patients would be enhanced by the active maintenance of contact by a practice healthcare professional. Screening of SSRI-users for diabetes is justified by both detection rate and the importance of establishing co-morbidity in terms of treatment decisions. Originality/value - Co-morbidity of diabetes and depression has been observed to result in a poor prognosis for the patient which can be tempered if successful engagement leads to early treatment of both conditions with a more tailored choice of medication and care.