Table 1 Operationalization of measures for guideline-recommended metabolic management
Parameter | Thresholds | Management elements | Operationalization | Data source |
|---|---|---|---|---|
Weight | BMI ≥30, weight gain >5% | Antipsychotic management | Switch to medication w/ lower propensity for weight gain | VA dataset |
Lifestyle modification | Counseling on diet, exercise, and behavior modification within 30 days, OR | Chart review | ||
Nutrition consult within 30 days, OR | VA dataset | |||
‘MOVE!’ Program encounter(s) within 30 days | VA dataset | |||
Medication | Orlistat prescription within 30 days | VA dataset | ||
Glucose | Plasma glucose ≥200 or Hgb A1c ≥6.5 | Antipsychotic management | Switch to medication with lower propensity for elevated glucose | VA dataset |
Lifestyle modification | Counseling on diet, exercise, and behavior modification within 30 days, OR | Chart review | ||
Nutrition consult within 30 days, OR | VA dataset | |||
‘MOVE!’ Program encounter(s) within 30 days | VA dataset | |||
Follow-up | Primary care/diabetes clinic visit within 30 days | VA dataset | ||
Medication | Hypoglycemic agent within 30 days | VA dataset | ||
Lipids | LDL ≥160 | Antipsychotic management | Switch to medication w/ lower propensity for elevated lipids | VA dataset |
Lifestyle modification | Counseling on diet, exercise, and behavior modification within 30 days, OR | Chart review | ||
Nutrition consult within 30 days, OR | VA dataset | |||
‘MOVE!’ Program encounter(s) within 30 days | VA dataset | |||
Follow-up | Primary care/medicine visit within 30 days | VA dataset | ||
Medication | Statin prescription within 30 days | VA dataset |