Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Medication Adherence for Hypertension (RAS antagonists)
Document related concepts
Transcript
MEDICATION ADHERENCE FOR HYPERTENSION Measurement Specifications for Star Ratings Program Measurement Description Percent of patients with a prescription for a blood pressure medication who fill their prescriptions often enough to cover 80% or more of the time they are supposed to be taking the medication. Measurement Source Pharmacy Quality Alliance (PQA) 2016 Denominator Patients 18 years of age or older as of the last day of the measurement period who filled at least two prescriptions for any of the Renin Angiotensin System (RAS) Antagonist blood pressure medications listed in Tables PDC-B on two unique dates of service in the measurement period. Drug Blood Pressure medications include: ACE (angiotensin converting enzyme) inhibitor, ARB Classes (angiotensin receptor blocker), a direct renin inhibitor, or ACEI/ARB/Direct Renin Inhibitor Combination products. Numerator Patients with a prescription for a Renin Angiotensin System (RAS) Antagonist blood pressure medication (see medication table above) who fill their prescriptions often enough to cover 80% or more of the time they are supposed to be taking their medications. Exclusion(s) Age Patients with End Stage Renal Disease (ESRD) < 18 Years old. ICD-10-CM codes: N18.5, N18.6, N19, I12.0, I13.11, I13.2, Z91.15, Z99.2 RxHCC code: 261 Page 1 of 2 December 2016 | Hypertension Medication Adherence Measurement Specifications Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross and Blue Shield Association Exclusion(s) continued ARB/Neprilysin Inhibitor Patients with one or more prescription claims for the medication, Combination Medication sacubitril/valsartan. Patients whose first fill of their medication occurs < 90 days before the end of the measurement year. Best Practice Develop a culture (i.e. protocol) of 90-day prescriptions and refills Reduce the number of daily doses of medications (i.e. BID, TID, QID); if at all possible, prescribe once daily medications. Educate patients on the importance of medication adherence Package medications into special containers (e.g. pill boxes or blister packs) Tele monitoring with interactive voice response technology Health coach for complex case management to address barriers to medication adherence Frequent clinic visits (every 2 months) Notes The calculation will adjust for stays in inpatient (IP) settings and hospice enrollments. Skilled Nursing Facility (SNF) stays are not adjusted. Measure is based on pharmacy claims data; at present there is no exclusion criteria to account for prescriber discontinuation of an agent for appropriate clinical reasons after the first two fills of the measurement period. Adherence to renin angiotensin system (RAS) antagonists is important for the chronic treatment of hypertension and proteinuria in patients with diabetes, in which these drugs have been shown to delay renal failure and heart disease. RAS antagonists are also important in treatment of heart failure, in which, along with beta-blockers, their use can lead to avoidance of hospitalizations and decreased mortality. Medications are the primary therapy for the most common diseases afflicting persons in the United States. There is evidence to support improvements in health for patients who are adherent to medications. For patients who have had a myocardial infarction, those who achieved adherence to statins, beta-blockers and angiotensin converting enzyme/angiotensin receptor blockers (ACE/ARBs), measured by proportion of days covered (PDC) greater than 80% had significantly better disease-free survival. (Choudhry et al., 2014) Source: https://www.qualitymeasures.ahrq.gov/summaries/summary/47493 2017 Star Ratings Performance Thresholds 1 STAR 2 STARS 3 STARS 4 STARS 5 STARS <71% >71% to <75% >75% to <79% >79% to <83% >83% Page 2 of 2 December 2016 | Hypertension Medication Adherence Measurement Specifications Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross and Blue Shield Association
