There was a six-fold difference between states with the highest and lowest rates of cardiovascular and glucose screening for beneficiaries who received antipsychotics (Figure 5). With the exception of a few states, between 40 percent and 60 percent of beneficiaries on antipsychotics received a cholesterol screening in 2007. Rates of glucose monitoring among those who received antipsychotics was much lower, ranging from 5 percent to 30 percent depending on the state.
States that performed best on medication monitoring for lithium and anticonvulsants also tended to perform quite well on screenings for beneficiaries receiving antipsychotics. The relationship between managed care enrollment and medication monitoring was unclear. In California and Indiana, antipsychotic users not enrolled in an HMO were respectively 8 and 13 percentage points more likely to receive a cholesterol screening than those in an HMO. However, antipsychotic users in an HMO were respectively 6 and 2 percentage points more likely to receive a glucose screening. Conclusions cannot be drawn from managed care enrollees in Maryland, due to missing data.