National Voluntary Consensus Standards for Medication Management

Purpose

This NQF project seeks to identify and endorse measures for public accountability and quality improvement related to medication management.

Background

The appropriate use of medications in the United States remains an important challenge. Despite improvements in health outcomes due to medication therapy, there is growing evidence that the frequent use of medications and especially multiple medications in chronically ill patients may lead to safety and quality problems.  It’s estimated that 81% of adults take at least 1 medication and 50% take at least 1 prescription drug, with 7% taking 5 or more.¹ Nearly 90 percent of Medicare beneficiaries report taking prescription medicines, and nearly half of those individuals use five or more different medications.²   Research suggests that between 14 and 23 percent of elderly patients receive inappropriate medications and up to 40 percent of patients do not take their medications as prescribed.³,⁴,⁵,⁶ Inappropriate medication use is responsible for a significant number of patient safety outcomes as well as resource waste.  Adverse drug events contribute to 2.5% of emergency department visits for unintentional injuries and 0.6% for all visits.⁷   Given the significant potential for harm from medications unless properly used and monitored, a robust set of measures that address medication management is required.

Previous NQF Work in This Area

NQF is currently finalizing a project to endorse a framework and preferred practices for Therapeutic Drug Management.

Scope of Activities

This project will seek to identify both process and outcome medication management measures that may be used to assess the impact of appropriate medication management. Measures will specifically include key aspects of medication decisionmaking, medication appropriateness and use, and monitoring.   The measures should address the quality of medication management provided by Medicare Part D plans, health plans, clinicians, and pharmacists.

The NQF Process

The candidate measures will be considered for NQF endorsement as voluntary consensus standards. Agreement around the recommendations will be developed through NQF’s formal Consensus Development Process (version 1.8). This project, like all NQF activities, involves the active participation of representatives from across the spectrum of healthcare stakeholders and is guided by a Steering Committee.

Funding

Primary support for this project is provided by the Centers for Medicare & Medicaid Services (CMS).

For further information, contact Kristyne McGuinn at 202-783-1300 or by email at medicationmanagement@qualityforum.org.

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