Assessment of response shift using two structural equation modeling techniques.

OBJECTIVE: To identify response shift using two structural equation modeling (SEM) techniques. STUDY DESIGN AND SETTING: Hypertensive patients (n = 909) with coronary artery disease (CAD) completed SF-36 surveys at both baseline and 1-year follow-up. Response shift was identified using Oort and Schmitt SEM techniques. The type of response shift linked to changes in various parameters of the SEM measurement model is defined differently for both SEM approaches. Effect sizes were calculated for the impact of response shift on the change of SF-36 domain scores when using the Oort approach. RESULTS: Both Oort and Schmitt SEM approaches identified response shift only in the SF-36 physical functioning (PF) scale. The effect size of recalibration on the change of PF domain scores when using the Oort approach was -0.12. CONCLUSION: This study showed that hypertensive patients with CAD experienced a response shift over a 1-year period. Both the SEM approaches identified response shift (uniform recalibration using the Oort approach and recalibration using the Schmitt approach); however, both approaches use different parameters to define and test response shift. We found that either the variation in analytic methods or the sample used may influence the identification and type of response shift.

Readiness of Pharmacists as Providers of Social Determinants of Health and Call to Action.

Social determinants of health (SDOH) are defined as the conditions in the environments where people are born, live, learn, work, play, worship, and age. SDOH has an enormous impact on achieving the goals set by Healthy People 2030. With their education and training, pharmacists are in an ideal position to provide SDOH services. Community pharmacists should take innovative approaches in collaboration with the Community Pharmacy Enhanced Services Network to develop standard protocols for SDOH and reimbursements for these services. Pharmacists not being recognized nationally as healthcare providers is the major barrier to the implementation and expansion of pharmacist-provided SDOH programs. Thus, approval of the Pharmacy and Medically Underserved Areas Enhancement Act (H.R. 2759) is crucial to overcoming this barrier. This legislation is designed to increase access to pharmacists who are primary care providers for rural and underserved populations. These practice changes align well with the American Association of Colleges of Pharmacy strategic priorities 1, 3, and 4. Moreover, one of the most important recommendations in the Pharmacy Forecast 2022 is to develop standardized SDOH protocols and integrate them into the daily workflow of pharmacists and pharmacy technicians. However, are pharmacists adequately prepared and motivated to engage in practices designed to mitigate SDOH challenges that impact patients' health, functioning, and quality-of-life outcomes and risk? This commentary urges pharmacy education programs to implement curricular modifications and pharmacy practice professionals to advocate, develop and implement best practice models for providing SDOH services.

Association Between Accreditation Era, North American Pharmacist Licensure Examination Testing Changes, and First-Time Pass Rates.

Objective. To estimate whether first-time pass rates on the North American Pharmacist Licensure Examination (NAPLEX) have been influenced by the number of pharmacy programs founded since 2000, the programs' accreditation era, and the changes to the blueprint as well as changes to the testing conditions and passing standards implemented by the National Association of Boards of Pharmacy (NABP) beginning in 2015.Methods. This was a retrospective, observational cohort study using publicly published data. The number of programs and pass rates were collected from 2008 to 2020. Programs reporting pass rates from 2016 to 2020 were eligible. Accreditation era was defined as programs accredited before or after 2000. Pass rates were categorized into NAPLEX tests administered before or after 2015. Statistical analyses were conducted for comparisons.Results. Pass rates were initially found to decline as the number of programs rose. First-time pass rates of programs accredited before 2000 were higher than pass rates of programs accredited after 2000 every year after 2011. Only 40% of the programs accredited after 2000 exceeded the national average between 2016-2020. Blueprint changes implemented in 2015 and the changes to testing conditions plus passing standards implemented in 2016 had a greater effect on pass rates than the number of programs or applicants.Conclusion. Programs accredited after 2000 generally had lower first-time NAPLEX pass rates. Even so, blueprint changes and changes to the testing conditions plus passing standards instituted by the NABP were more important predictors of the decline of first-time NAPLEX pass rates. Stakeholders should collaborate and embrace best practices for assessing practice-ready competency for licensure.

SF-6D utility index as measure of minimally important difference in health status change.

OBJECTIVES: To combine anchor- and distribution-based approaches to identify minimally important differences (MIDs) for the short-form six-dimension utility index (SF-6D) and to identify variables associated with self-reported health status change. DESIGN: Descriptive, exploratory, nonexperimental study. SETTING: United States between April 1, 1999, and October 31, 1999. PATIENTS: 2,317 participants of SADD-Sx (Study of Antihypertensive Drugs and Depressive Symptoms), aged 50 years or older and with hypertension and coronary artery disease. INTERVENTION: Patients were randomized into a verapamil SR- or atenolol-led hypertensive treatment strategy and mailed baseline and 1-year surveys. MAIN OUTCOME MEASURE: SF-6D utility scores for patients completing both surveys. RESULTS: The pooled mean (±SD) MID change on the SF-6D of patients whose health status minimally changed was 0.035 ± 0.095. The anchor-based change scores had a median value of 0.036 (interquartile range -0.03 to 0.10). One-third and one-half of the SD of SF-6D change scores were 0.035 and 0.053, respectively. Whites were less likely to report minimally improved health status compared with nonwhites (odds ratio 0.59 [95% CI 0.40-0.88]). Change in SF-6D scores improved prediction of health status change. CONCLUSION: We recommend using the MID range based on all patients combined (-0.03 to 0.10) to interpret SF-6D scores. These estimates can be used in conjunction with other measures of efficacy to determine meaningful changes. SF-6D demonstrates potential utility in predicting minimally important improvement or worsening among patients receiving different pharmacologic medications.

Role of the pharmacist in preventing distribution of counterfeit medications.

OBJECTIVE: To provide an overview of the counterfeit medication problem and recommendations of a joint American Pharmacists Association (APhA) Academy of Pharmaceutical Research and Science and APhA Academy of Pharmacy Practice and Management taskforce. DATE SOURCES: SciFinder and PubMed were searched from 1980 to March 2011 using the following keywords: counterfeit drug product, counterfeit medications, drug product authentication, drug product verification, and track-and-trace. Publications, presentations, and websites of organizations that research the counterfeit medication problem in the United States and other countries were reviewed. A representative from the security division of a pharmaceutical manufacturer and a representative from a supplier of anticounterfeiting technologies gave presentations to the taskforce. SUMMARY: The taskforce recommends that pharmacists (1) purchase medications from known, reliable sources; (2) warn patients of the dangers of purchasing medications over the Internet; (3) confirm with distributors that products were purchased from manufacturers or other reliable sources; (4) monitor counterfeit product alerts; (5) examine products for suspicious appearance; (6) work with the pharmaceutical industry, distributors, and the Food and Drug Administration (FDA) to close gaps in the supply chain, especially for drugs in short supply; (7) use scanning technology in the pharmacy as part of a prescription verification process; (8) educate themselves, coworkers, and patients about the risks of counterfeit medications; and (9) report suspicious medications to FDA, the distributor, and the manufacturer. CONCLUSION: The consequence of a patient receiving a counterfeit medication in the United States could be catastrophic, and pharmacists must play an active role in preventing such an event from occurring.

Selective serotonin reuptake inhibitor treatment and depression are associated with poststroke mortality.

BACKGROUND: Studies generally do not examine patients' prestroke depression diagnoses and treatments. OBJECTIVE: To examine the association of depression diagnosis and prestroke and/or poststroke selective serotonin reuptake inhibitor (SSRI) treatment with poststroke mortality. METHODS: We conducted a retrospective study of the medical records of a cohort of veterans with a stroke diagnosis between July 31, 2000, and September 30, 2001. Data regarding demographics, comorbidities, depression diagnosis, and treatment were abstracted from automated databases and electronic medical records for 6 months before and 1 year after the stroke index date. The survival rates of veterans who received an SSRI before and/or after the stroke were estimated using Kaplan-Meier survival analysis. Time-dependent Cox proportional hazards regression model was used to assess the association between risk factors and mortality. RESULTS: Among 870 veterans, 80 died less than 60 days after their stroke. Among the remaining 790, 12% died within 1 year, 26% died by the end of follow-up (May 1, 2007), and more than 62% were alive at the end of follow-up. Veterans were 3 times as likely to die if they had been treated for depression with an SSRI only before their stroke (hazard ratio [HR], 3.12; 95% CI 1.60 to 6.09). In the time-dependent model, SSRI treatment both before and after the stroke was protective compared with no SSRI treatment during the year following the stroke (HR 0.31; 95% CI 0.11 to 0.86). However, the survival curves crossed over and SSRI treatment before and after stroke conferred greater risk at the end of 7 years (HR 1.36; 95% CI 1.00 to 1.87). Depression diagnosis was associated with greater risk of mortality (HR 1.87; 95% CI 1.24 to 2.82). CONCLUSIONS: Poststroke SSRI treatment was associated with longer survival even though depression diagnosis was associated with earlier mortality in the unadjusted model. After a stroke, SSRI initiation or resumption of treatment should be considered as part of a medication therapy management service, especially if the patient has a history of depression or was taking an SSRI before the stroke.

Impact of antidepressant dispensing on health service use among veterans with stroke.

OBJECTIVE: To examine the association between dispensing of a selective serotonin reuptake inhibitor (SSRI) antidepressant medication and inpatient and outpatient service use in a cohort of veterans with confirmed acute stroke. DESIGN: Retrospective study. SETTING: Southeastern U. S. Veterans Health Administration (VHA) network, from October 1, 2000, to September 30, 2001. PATIENTS: 785 veterans with confirmed acute stroke. INTERVENTION: VHA and Medicare databases were used to obtain outcome information during the 12 months after the index stroke date. MAIN OUTCOME MEASURES: Number of inpatient admissions, length of inpatient stays, and number of outpatient clinic stops for all causes. RESULTS: Among the study cohort (n = 785), 12% had an SSRI dispensed 30 days or less poststroke, 19% had an SSRI dispensed between 31 and 365 days poststroke, and 69% were not dispensed an SSRI poststroke. After adjusting for risk factors, no significant association was found between time to first SSRI dispensing and inpatient use. However, patients with an early SSRI dispensing were more likely to have a greater number of all-cause outpatient stops compared with patients with later or no SSRI dispensing. Regardless of time to first dispensing, patients dispensed an SSRI had more outpatient clinic stops than patients without the medication. CONCLUSION: SSRI dispensing was not predictive of inpatient use but was a strong predictor of all-cause outpatient clinic stops.

Risks, benefits, and issues in creating a behind-the-counter category of medications.

OBJECTIVE: To examine the issues surrounding the development and implementation of a behind-the-counter (BTC) category of medications. DATA SOURCES: Testimony from organizations submitting comments to the Food and Drug Administration (FDA) panel hearings in November 2007, the 2009 final report of the U. S. General Accounting Office regarding a BTC drug category, literature review of research that has been conducted, experiences from other countries, and publically available information from agencies in charge of regulating medications similar to BTC. SUMMARY: Based on evidence attained from the current work, the following six recommendations regarding a BTC category of medications are provided. (1) Demonstration needs to occur that the risks and/or costs of BTC are outweighed by benefits, positive measurable outcomes, and financial savings to society. (2) Sufficient resources, including personnel, equipment, and facilities, need to be available for the appropriate provision of BTC services and to ensure ongoing monitoring and controls. (3) An appropriate compensation structure needs to be developed. (4) Encounters and outcomes should be documented in an electronic record, the information should be shared with other health care providers involved in patients' care, and interprofessional collaboration and communication should occur. (5) Criteria for designating candidates for transition, ongoing review for safety, and reverse transition must be developed. (6) Applicable lessons learned from other countries should be incorporated into BTC strategies. In addition to implementation recommendations, we also summarize additional evidence that needs to be gathered to optimize the BTC model. CONCLUSION: Based on the accumulated evidence, comments to FDA's request, and information from other countries, implementation of a BTC model probably is feasible in the United States. However, the optimal model remains uncertain and various aspects of a program need to be prioritized and rigorously tested.

Predicting the 2016 US News & World Report rankings using a reputation and prestige model.

INTRODUCTION: The objective was to determine institutional, faculty, and student attributes predictive of the 2016 US News & World Report (USNWR) pharmacy rankings and to explore if student attributes modify program rankings. METHODS: Institutional attributes and student and faculty resources and outcomes were obtained from various sources. Regression analyses predicted rankings. RESULTS: USNWR rankings were higher for older programs, those located at an academic health center or classified as a research-intensive institution, and members of a Power Five athletic conference. Number of fulltime equivalent faculty, Pharmacy College Admissions Test composite percentile, pharmacy practice h-index score, funding rank, and first time North American Pharmacist Licensure Examination (NAPLEX) pass rate predicted higher rankings. Nearly 45% of programs in the empiric models left or entered the top 25 rankings compared with the existing USNWR method (range 31 place increase to 22 place decrease). Among USNWR top 25 ranked programs, 16 remained in the top 25 in all four empiric models and three were not included in any of the models. Six USNWF unranked programs moved into the top 25 by one or more of the empiric models. CONCLUSIONS: Faculty and student attributes significantly impact program rankings, while impact of institutional attributes is negligible if independent of student and faculty attributes. Faculty numbers and productivity influence USNWR rankings more than student academic preparation and success on NAPLEX. These findings will inform efforts to improve the validity of the USNWR rankings and identify programs that are both prestigious and of high quality.

Does prestroke depression impact poststroke depression and treatment?

OBJECTIVES: To 1) describe the prevalence of before the stroke depression (BSD) and poststroke depression (PSD) and 2) serotonin selective reuptake inhibitor (SSRI) treatment patterns. DESIGN: Naturalistic, retrospective cohort design. SETTING: Veterans Healthcare System. PARTICIPANTS: Seven hundred ninety veterans with confirmed stroke during fiscal year 2001. MEASUREMENTS: Diagnosis of depression and dispensing for antidepressants before and after stroke. RESULTS: A depression diagnosis was noted for nearly 10% (N = 74) of veterans before their stroke and nearly 26% afterward (N = 205). Among those with a BSD diagnosis, 75.7% received a PSD diagnosis after their stroke. Only 20.9% of the veterans without a BSD diagnosis received a PSD diagnosis afterward (odds ratio [OR] = 9.5, 95% confidence interval [CI] = 5.4-16.5). Nearly 32% were dispensed a SSRI. Veterans receiving an SSRI before their stroke were more likely to receive one afterward (OR = 31.9, 95% CI: 17.4-58.4). Nearly 48% of those with a BSD diagnosis were dispensed an SSRI < or =30 days if they had a PSD diagnosis < or =30 days, but 48% without a PSD diagnosis were still dispensed an SSRI < or =30 days if they had a BSD diagnosis. Conversely, among those without a BSD diagnosis, 39.4% were dispensed an SSRI < or =30 days if they had a PSD diagnosis but only 7.2% without a PSD diagnosis in < or =30 days with no BSD diagnosis. CONCLUSION: Patients' depression status before the stroke is a significant predictor of PSD and providers' SSRI prescribing behavior but not age. Given the deleterious effects of PSD, physicians may be tending toward prophylaxis or early treatment even before the evidence to support such treatment leads to standard practice recommendations.

Length of advanced pharmacy practice experience and first-time NAPLEX pass rate of US pharmacy programs.

INTRODUCTION: The objectives of this study were to (1) report the length in weeks of advanced pharmacy practice experiences (APPEs) of US pharmacy programs in 2016 and (2) compare first-time North American Pharmacy Licensure Examination (NAPLEX) pass rates according to the length in weeks of the programs' APPEs. METHODS: First-time NAPLEX pass rate was obtained from the National Association of Boards of Pharmacy public web page. The length in weeks of programs' individual APPEs (iAPPEs) and program characteristics were obtained from the individual pharmacy programs' web pages. Analysis of variance was used to compare iAPPE length and first-time NAPLEX pass rate and multiple regression was used to quantify the independent influence of iAPPE length on first-time NAPLEX pass rate. RESULTS: The length in weeks was evenly distributed among four-, five- and six-week iAPPEs for NAPLEX testing years 2013 to 2015, although six-week iAPPEs have been preferred recently. The first-time NAPLEX pass rate was not associated with the total APPE length or whether the program used four-, five- or six-week iAPPEs for all three years and for the three-year aggregate pass rate. CONCLUSION: Six-week iAPPEs were the most common, but not the majority among pharmacy programs. Longer total or individual APPEs did not translate into higher first-time NAPLEX pass rates. Length of iAPPE rotations can be chosen without concern that student pharmacists' performances on first-time NAPLEX pass rates will be significantly impacted.

Elucidation of a resource reputation model to explain US News & World Report ranking using path analysis.

INTRODUCTION: The US News & World Report (USNWR) ranking is based on a reputation and prestige survey mailed to academic peers. This study's goal was to determine direct and indirect institutional, faculty, and student attributes predictive of the 2016 USNWR pharmacy rankings. METHODS: The Resource and Reputation Model (RRM) explains the development of perceptions of reputation and prestige. Institutional characteristics as well as student and faculty resources and outcomes were obtained from various sources. Path analysis determined the total, direct, and indirect effects. RESULTS: USNWR rankings were higher if programs were older, affiliated with an academic health center, classified as a research-intensive institution, and members of a Power 5 football conference. Program rank was predicted by the number of full-time faculty equivalents and pharmacy practice h-index score and funding. Pharmacy College Admissions Test comprehensive percentile and first-time North American Pharmacy Licensure Examination (NAPLEX) pass rate were also predictive of higher rank. All but affiliation with an academic health center or research-intensive institution directly predicted rank, but they had indirect impact through programmatic quality attributes. CONCLUSIONS: The RRM helps to explain pharmacy programs' USNWR rankings. Elucidation of its components provide insight into explaining the rankings and improving the methodology. Academic pharmacy could work with USNWR to develop criteria-based objective methodology to validate and improve rankings. Faculty, faculty productivity, and student academic preparation and success on NAPLEX influence USNWR rankings more than immutable factors such as program age and affiliations.

A medication therapy management program's impact on low-density lipoprotein cholesterol goal attainment in Medicare Part D patients with diabetes.

OBJECTIVES: To determine a medication therapy management (MTM) service's impact on (1) Healthcare Effectiveness Data and Information Set (HEDIS) quality measures and (2) use and cost expenditures. DESIGN: Nonequivalent group, quasiexperimental study. SETTING: Florida, January 1, 2006, through September 30, 2007. PARTICIPANTS: 2,114 Florida Health Care Plans Medicare Part D enrollees with diabetes. INTERVENTION: Intervention group participated in the MTM program during the HEDIS measurement year. MAIN OUTCOME MEASURES: Presence of low-density lipoprotein cholesterol (LDL-C) screening, LDL-C values, and LDL-C control (<100 mg/dL). The use measure was the total number of 30-day medication equivalents. Cost measures were (1) total Medicare Part D drug cost, (2) enrollees' out-of-pocket Part D medication costs, and (3) total medication copayments. Statistical analyses included chi-square, independent and paired t tests, and analysis of variance with post hoc comparisons. RESULTS: Of 2, 114 enrollees eligible for comprehensive diabetes care (CDC) according to HEDIS guidelines, 255 participated in the MTM intervention group and 56 patients were MTM eligible but opted out of the program or could not be reached for medication review during 2008 (MTM nonparticipants). A higher proportion of patients in the MTM participant group had LDL-C levels less than 100 mg/dL (69.0%) compared with those in the MTM nonparticipant (50.0%) and CDC only (54.1%) groups (chi2 = 20.9(3), P < 0.001). The two control groups' average LDL-C (90.8 and 93.6 mg/dL) was significantly higher than the intervention group (83.4 mg/dL, P < 0.001). Overall, per member per month use and drug costs differed from 2007 to 2008 and enrollees in the MTM participant group had greater percentage cost reductions. CONCLUSION: Enrollees who were eligible for MTM services but did not receive them had poorer clinical, use, and cost outcomes compared with the MTM intervention group. Pharmacists collaborating with physicians through a MTM program can improve quality of metrics for chronic diseases and reduce medication costs.

Glucose dysregulation among veterans living with schizophrenia-related disorders after switching second-generation antipsychotics.

OBJECTIVES: To compare (1) blood glucose and glycosylated hemoglobin (A1C) laboratory results and (2) longitudinal trends in blood glucose levels among veterans switched from one second-generation antipsychotic (SGA) to another. DESIGN: Retrospective, naturalistic, nonequivalent control group. SETTING: United States between April 1, 2003, and September 30, 2003. PATIENTS: 1,776 U.S. Veterans Health System beneficiaries living with schizophrenia-related disorders switching (1) from olanzapine to another SGA, (2) to olanzapine from another SGA, and (3) among nonolanzapine SGAs. INTERVENTION: Data were retrieved from the laboratory results (LAR) database for a maximum of 180 days before and 365 days after the index date. MAIN OUTCOME MEASURES: Mean blood glucose, A1C, and change in blood glucose. RESULTS: Blood glucose (36.0 mg/dL, paired t test109 = -4.87, P < 0.001) and A1C (1.0%, paired t143 = -4.84, P < 0.001) declined among veterans switched from olanzapine who were taking a blood glucose-lowering agent before the switch but was unchanged for those who were not. Adjusting for age, gender, and race, addition of the switch-type variables improved prediction of blood glucose change (F-ratio = 3.76, P = 0.03). Linear mixed-effects models confirmed that blood glucose levels declined for veterans switched from olanzapine with glucose dysregulation before the switch (Est(beta2 - beta1) = -34.5 mg/dL, t424 = -5.05, P < 0.001). CONCLUSION: Blood glucose and A1C were significantly improved among veterans switched from olanzapine with evidence of glucose dysregulation before the switch. They were stable among those without evidence of preexisting glucose dysregulation. Therapeutic switches from one SGA to another should be monitored as a risk factor for changes in glucose regulation.

Impact of Completion of a Pre-Pharmacy Biochemistry Course and Competency Levels in Pre-Pharmacy Courses on Pharmacy Student Performance.

Poor performance in foundational science courses, which are usually taken during the first or second year of pharmacy school, can have several negative consequences including increases in student drop-out rates and increases in the number of dismissals and remediating students. The primary goal of the current study was to determine whether completion of a pre-pharmacy biochemistry course and/or performance on a biochemistry competency test (administered at the beginning of the pharmacy program) are associated with pharmacy student performance in foundational science courses and overall academic performance. A secondary goal was to determine whether performance in pre-pharmacy courses and/or student demographics are associated with pharmacy student performance. Prospective univariate analyses (n = 75) determined that completion of a pre-pharmacy biochemistry course is not associated with pharmacy student performance. However, performance on a biochemistry competency test was associated with performance in Biochemistry and Cell&Molecular Biology (p = 0.002). Furthermore, post-hoc analyses determined that pre-pharmacy cumulative chemistry GPA correlates with performance in both the Biochemistry and Cell&Molecular Biology and Medicinal Chemistry foundational science courses (p = 0.002 and p = 0.04, respectively) and can predict first year GPA (p = 0.002). The combined data indicate that further assessment of the impact of pre-pharmacy competency in biochemistry and chemistry on pharmacy student success is warranted.

Practice-based research networks: Keeping the highway running through the pharmacy community.

This issue of the Journal of the American Pharmacists Association focuses on a topic vital to the pharmacy profession-practice-based research networks (PBRNs) of pharmacy practitioners and researchers. Now, vital is a pretty value-based word and is in the eye of the beholder. Why do we think pharmacy practice-based research is vital? During our many years as practitioners, faculty members, and pharmacy leaders, the phrase "pharmacy is at a crossroad" has been overused regularly. One could say that we are now at another professional crossroad, but crossroads probably understates the seriousness of the times; potentially, we are at a "bypass." Let us use an analogy to illustrate our concerns and then tell you why we think the profession is at a bypass.

Metabolic monitoring in veterans with schizophrenia-related disorders and treated with second-generation antipsychotics: findings from a Veterans Affairs-based population.

OBJECTIVES: To describe the proportions of veterans living with schizophrenia-related disorders monitored for dyslipidemia and hyperglycemia and to investigate whether the likelihood of metabolic dysregulation monitoring was influenced by veterans' sociodemographic characteristics, preswitch pharmacologic treatment, and monitoring before the switch from one second-generation antipsychotic (SGA) to another. DESIGN: Retrospective, observational, descriptive study. SETTING: Veterans Affairs (VA) Healthcare System between October 1, 2001, and December 31, 2003. PATIENTS: 1,826 veterans with schizophrenia-related disorders. INTERVENTION: Veterans who were dispensed two or more prescriptions for one of five SGAs (i.e., clozapine, olanzapine, quetiapine, risperidone, and ziprasidone) on the VA Healthcare System formulary were identified. Of these veterans, a subset that was switched from one SGA to another was identified. From this subset, veterans were identified who were on the first SGA continuously for at least 90 days before the index date and the new SGA for 180 or more days after. Finally, among these veterans, ICD-9 codes were used to identify veterans with a schizophrenia or schizoaffective disorder diagnosis (ICD-9 code 295.xx or 296). MAIN OUTCOME MEASURES: Proportions of veterans with lipid (i.e., low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) and blood glucose (i.e., fasting blood glucose [FBG], glycosylated hemoglobin [A1C]) laboratory results. RESULTS: Nearly 39% of the veterans had at least one of three lipid fractions monitored 6 months or less before their SGA switch and 59% during the 12 months after. The corresponding proportions of veterans monitored were 57% and 80% for FBG and 19% and 31% for A1C. Pharmacologic agent for metabolic dysregulation, monitoring during the 6 months before the switch, and age 50 years or older were significant predictors of monitoring after the SGA switch for all three laboratory parameters. CONCLUSION: These findings serve as a benchmark for lipid and blood glucose monitoring among patients who switch SGA therapy. Veterans' metabolic dysregulation was more likely to be monitored after SGA switch for those receiving pharmacologic treatment for metabolic dysregulation, monitored before the switch, and aged 50 years or older. Implementation of monitoring guidelines in daily practice is emphasized to ensure that individuals living with schizophrenia-related disorders and taking SGAs achieve optimal physical health.