Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) (NQF 0081)

eMeasure Name Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) eMeasure Id 76bccfa7-273b-4932-8d4e-5253aa1dc79c
Version number 1 eMeasure Set Id de9bcd6e-e0e9-4571-8215-d0b03632e0f0
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 heart failure and LVSD (LVEF < 40%) who were prescribed ACE inhibitor or ARB therapy.
Copyright
© 2010 American Medical Association. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
In the absence of contraindications, ACE Inhibitors or ARBs are recommended for all patients with symptoms of heart failure and reduced left ventricular systolic function, as measured by left ventricular ejection fraction (LVEF). Both drugs have been shown to decrease mortality and hospitalizations. Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD).
Clinical Recommendation Statement
Angiotensin converting enzyme inhibitors are recommended for all patients with current or prior symptoms of HF and reduced LVEF, unless contraindicated. (Class I Recommendation, Level of Evidence: A)(ACC/AHA) Angiotensin II receptor blockers approved for the treatment of HF are recommended in patients with current or prior symptoms of HF and reduced LVEF who are ACEI-intolerant. (Class I Recommendation, Level of Evidence: A) (ACC/AHA) Angiotensin II receptor blockers are reasonable to use as alternatives to ACEIs as first-line therapy for patients with mild to moderate HF and reduced LVEF, especially for patients already taking ARBs for other indications (Class IIa Recommendation, Level of Evidence: A) (ACC/AHA).
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline update for the diagnosis and management of chronic heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112:e154-e235.
Reference
Jessup M, Abraham WT, Mancini DM, et al.  DRAFT 2009 focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults:  a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines developed in Collaboration With the American Academy of Family Physicians, American College of Chest Physicians, Heart Failure Society of America, and International Society for Heart and Lung Transplantation (Writing Group to Review new evidence and update the 2005 guideline for the management of patients with chronic heart failure) developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung.
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 heart failure (HF). 
Encounter:  At least 2 ambulatory visits (or 1 inpatient discharge) 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 Heart failure and left ventricular ejection fraction (LVEF) < 40% or with moderately or severely depressed left ventricular systolic function
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Patients who were prescribed ACE inhibitor or ARB therapy
Definition
Denominator Exception(s): Documentation of medical reason(s) for not prescribing angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy (eg, clinical contraindication, drug allergy, drug interaction, drug intolerance, other medical reason(s))
Documentation of patient reason(s) for not prescribing angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy (eg, patient declined)
Documentation of system reason(s) for not prescribing angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy
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