National Quality Forum Endorses Measures to Improve Medication Safety and Quality
Washington DC (August 17, 2009) - To improve the quality and safety of medication use in the United States, the National Quality Forum (NQF) endorsed 18 measures for managing over the counter and prescription medications. The 18 endorsed measures assess prescribing and use of appropriate medications and medication adherence, reconciliation, and monitoring. The measures are among the first to be endorsed for medication management and help to highlight gaps in measurement and quality improvement for medication use and adherence.
Nearly 90 percent of Medicare beneficiaries take prescription medicine and almost half use five or more different medications. Up to 40 percent of patients do not take their medications as prescribed, and an estimated 1.5 million preventable adverse drug events occur each year. Yet, there are few standards available to measure and improve the quality and safety of medication use and management.
“Medications offer relief and life-saving treatment to millions of people across the country each day, but more must be done to measure and improve the quality and safety of medication adherence and management,” said Janet Corrigan, NQF president and CEO. “These measures are a starting point to improve quality and lay the groundwork for additional measure development for continued improvement in medication management.”
The NQF-endorsed measures focus on measuring and improving adherence and management of medication for a range of conditions where medication nonadherance is prevalent and results in severe adverse outcomes. Conditions include diabetes, asthma, coronary artery disease, kidney disease, chronic obstructive pulmonary disease, and schizophrenia.
The endorsed measures for adherence measure things like adherence of antipsychotics among patients with schizophrenia, and medication possession for statin therapy for patients with coronary artery disease. Other measures focus on medication reconciliation and review by measuring the percentage of adults over 65 who had a medication review, or the percentage of discharged patients over 65 whose medications were reconciled.
A previously endorsed framework guided the endorsement of medication management measures in the areas of adherence and education; decision-making; prescribing; safe medication use; and system coordination and communication.
NQF’s steering committee on medication management was co-chaired by Harold Pincus, director of quality and outcomes research at New York Presbyterian Hospital and Health System, and Paul Conlon, JD, PharmD, Senior Vice President of Clinical Quality and Patient Safety at Trinity Health.
“These measures for medication management add some standardization and clarity to the field of medication management,” said Pincus. “NQF’s attention to this topic helps identify gaps in measurement and pushes the field toward more and better measures for quality improvement in medication management.”
NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via e-mail no later than September 15 (appeals@qualityforum.org). For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.
This work was conducted under a contract from the Centers for Medicare & Medicaid Services.
MM-001-08: Proportion of Days Covered (PDC): 5 Rates by Therapeutic Category*
MM-003-08: Adherence to Chronic Medications*
MM-004-08: Coronary Artery Disease and Medication Possession Ratio for Statin Therapy*
MM-005-08: Use and Adherence to Antipsychotics Among Members with Schizophrenia*
MM-006-08: Diabetes Mellitus and Medication Possession Ratio (MPR) for Chronic Medications*
MM-010-08: Diabetes and Medication Possession Ratio for Statin Therapy*
MM-014-08: Chronic Kidney Disease, Diabetes Mellitus, Hypertension, and Medication Possession Ratio for ACEI/ARB Therapy*
MM-017-08: Ace Inhibitor/Angiotensin Receptor Blocker Use and Persistence Among Members with Coronary Artery Disease at High Risk for Coronary Events*
MM-008-08: Diabetes Suboptimal Treatment Regimen (SUB)
MM-011-08: Suboptimal Asthma Control (SAC) and Absence of Controller Therapy (ACT)
MM-013-08: Pharmacotherapy Management of COPD Exacerbation (PCE): Two rates are reported
MM-022-08: HBIPS-4: Patients Discharged on Multiple Antipsychotic Medications and HBIPS-5 Patients Discharged on Multiple Antipsychotic Medications with Appropriate Justification (paired measure)
MM-026-08: Care for Older Adults — Medication Review (COA)
MM-028-08: Medication Reconciliation Post-Discharge (MRP)
MM-030-08: Monthly INR Monitoring for Beneficiaries on Warfarin
MM-031-08: INR for Beneficiaries Taking Warfarin and Interacting Anti-Infective Medications
MM-034-08: HBIPS-6 Post-Discharge Continuing Care Plan Created
MM-035-08: HBIPS-7 Post-Discharge Continuing Care Plan Transmitted to Next Level of Care Provider upon Discharge
*Time-limited endorsement
