Hepatitis C: Antiviral Treatment Prescribed (NQF 0397)

eMeasure Name Hepatitis C: Antiviral Treatment Prescribed eMeasure Id 2270EEC6-61C3-452F-89FC-BB78B6F5A6C1
Version number 1 eMeasure Set Id A2EC09A7-1797-46A2-A4B5-A5EC4C87D484
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association - Physician Consortium for Performance Improvement
Endorsed by National Quality Forum
Description Percentage of patients aged 18 years and older with a diagnosis of chronic hepatitis C who were prescribed peginterferon and ribavirin therapy within the 12 month reporting period
Copyright
© 2010 American Medical Association. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
Assure that antiviral therapy is prescribed. The current standard of care for the treatment of previously untreated patients with chronic hepatitis C is combination pegylated interferon (PEG-IFN) alfa by subcutaneous injection once a week and oral ribavirin daily. For patients with contraindications to ribavirin but who have indications for antiviral therapy, PEG-IFN represents the best available treatment. (AGA, 2006). Current contraindications to therapy include decompensated cirrhosis, pregnancy, uncontrolled depression or severe mental illness, active substance abuse in the absence of concurrent participation in a drug treatment program, advanced cardiac or pulmonary disease, severe cytopenias, poorly controlled diabetes, retinopathy, seizure disorders, immunosuppressive treatment, autoimmune diseases, or other inadequately controlled comorbid conditions.(AGA, 2006). Data elements required for the measure can be captured and the measure is actionable by the physician.
Clinical Recommendation Statement
The treatment of choice is peginterferon plus ribavirin (Grade I). (AASLD, 3004). The current standard of care for the treatment of previously untreated patients with chronic hepatitis C is combination pegylated interferon (PEG-IFN) alfa by subcutaneous injection once a week and oral ribavirin daily. For patients with contraindications to ribavirin but who have indications for antiviral therapy, PEG-IFN represents the best available treatment (Category I). (AGA) Current contraindications to therapy include decompensated cirrhosis, pregnancy, uncontrolled depression or severe mental illness, active substance abuse in the absence on concurrent participation in a drug treatment program, advanced cardiac or pulmonary disease, severe cytopenias, poorly controlled diabetes, retinopathy, seizure disorders, immunosuppressive treatment, autoimmune diseases, or other inadequately controlled comorbid conditions (Category I). (AGA, 2006). Combination therapy results in better treatment responses than monotherapy, but the highest response rates have been achieved with pegylated interferon in combination with ribavirin. (NIH, 2002).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
American Gastroenterological Association (AGA) technical review on the management of hepatitis C. Gastroenterology. 2006 Jan; 130(1): 231-264.
Reference
Dienstag JL, McHutchinson JG. American Gastroenterological Association (AGA) medical position statement on the management of hepatitis C. Gastroenterology. 2006 Jan; 130 (1): 225-30.
Reference
Stradler DB, Wright T, Thomas DL, Seeff LB. American Association for the Study of Liver Diseases (AASLD) practice guidelines: Diagnosis, management and treatment of hepatitis C. Hepatology. 2004 April: 1147-1171.
Reference
National Institutes of Health (NIH). Management of hepatitis C: 2002. Rockville (MD): National Institutes of Health (NIH); 2002 Aug 26.
Definition
Initial Patient Population(s): Patient Age:  Patients aged 18 years and older at the beginning of the measurement period.
Diagnosis Active:  Patient has a documented diagnosis of chronic Hepatitis C. 
Encounter:  At least 2 visits with the physician, physician’s assistant, or nurse practitioner during the measurement period.
Definition
Denominator(s): All patients aged 18 years and older with a diagnosis of chronic Hepatitis C
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Patients who were prescribed peginterferon and ribavirin therapy within the 12 month reporting period.
Definition
Denominator Exception(s): Documentation of medical reason(s) for not prescribing peginterferon and ribavirin therapy (eg, patient was not a candidate for therapy, could not tolerate).
Documentation of patient reason(s) for not prescribing peginterferon and ribavirin therapy (eg, patient declined)
Documentation of system reason(s) for not prescribing peginterferon and ribavirin therapy (eg, patient has no insurance coverage, therapy not covered).
Guidance
Supplemental Data Elements
Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)".

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Supplemental Data Elements




Measure set CLINICAL QUALITY MEASURE SET 2011-2012