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Table 1 Operationalization of measures for guideline-recommended metabolic management

From: Monitoring and managing metabolic effects of antipsychotics: a cluster randomized trial of an intervention combining evidence-based quality improvement and external facilitation

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