Access the Final Report: National Voluntary Consensus Standards for Medication Management
Endorsed Measures
The Opportunity
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. Performance measures that provide more targeted information about the process and outcomes of medication management can lead to better identification of areas for potential quality improvement.
Statistics
It’s estimated that 81 percent of adults in the United States take at least one medication and 50 percent take at least one prescription drug.1 Nearly 90 percent of Medicare beneficiaries report taking prescription medicines and nearly half of those individuals use 5 or more 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 poor patient safety outcomes as well as resource waste. Adverse drug events contribute to 2.5 percent of emergency department visits for unintentional injuries and 0.6 percent for all visits.7
About the Project
This project was initiated in August 2008.
Objectives
This project seeks to identify both process and outcome measures that may be used to assess the impact of appropriate medication management. Measures will specifically include key aspects of medication decision making, 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.
Process
Candidate measures will be considered for NQF endorsement as national voluntary consensus standards. Agreement will be developed through NQF’s Consensus Development Process (CDP, version 1.8). This project 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 and Medicaid Services (CMS).
Related NQF Work
Therapeutic Drug Management
Contact Information
For additional information please call 202-783-1300 or email medicationmanagement@qualityforum.org.
Notes
- Kaufman DW, Kelly JP, Rosenberg L, et al. Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States. JAMA: 2002; 287:337-344.
- Bedell SE, Jabbour S., Golbert R, et al. Discrepancies in the use of medications. Arch Int Med: 2000; 160(14):2129 – 2134.
- Aparasu R, Mort J. Inappropriate prescribing for the elderly: Beers criteria-based review. Ann Pharmacother 2000; 34:338-46.
- Stuck A, Beers M, Steiner A et al. Inappropriate medication use in the community-residing older persons. Arch Intern Med 1994;154:2195-2200.
- Chrischilles E, Segar E, Wallace R. Self-reported adverse drug reactions and related resource use: A study of community-dwelling person 65 years of age and older. Ann Intern Med 1992;117:634-40.
- Bond W, Hussar D. Detection methods and strategies for improving medication compliance. Am J Hosp Pharm 1991;48:1978-88.
- Bond W, Hussar D. Detection methods and strategies for improving medication compliance. Am J Hosp Pharm 1991;48:1978-88.
In this project, NQF seeks to identify and endorse both process and outcome measures for public accountability and public improvement related to medication management.
The project Steering Committee, representing the full range of stakeholder perspectives, was formed following the process set forth in NQF’s Consensus Development Process. Nominations were accepted from August 21 through September 23, 2008.
Steering Committee Roster
NQF received 37 measures to review for potential endorsement as national voluntary consensus standards. Submissions were accepted from August 21 through September 23, 2008.
Submitted Measures
The Steering Committee met in person and by conference call numerous times from November 2008 through May 2009. They reviewed all submissions and communicated with measure developers as needed to determine the measures to recommend for endorsement. Following this review period, the recommended measures were made available for public and member comment.
The Steering Committee convened for the first time via conference call on November 12, 2008.
The Steering Committee Meeting met in person on December 3, 2008.
Meeting Summary
The Steering Committee held a conference call on May 22, 2009, to discuss the comments submitted during the public and member comment period.
Agenda
The CSAC reviewed the recommended standards at an in-person meeting on July 15 and 16, 2009.
Meeting Summary
The NQF Board of Directors ratified CSAC’s decision to endorse 18 measures for medication management.
No appeals were submitted on the endorsement of these measures for medication management.
