Asthma Pharmacologic Therapy (NQF 0047)

eMeasure Name Asthma Pharmacologic Therapy eMeasure Id 7675E1C0-E7A9-4823-9BB4-BDBD4DE2D873
Version number 1 eMeasure Set Id 37E4DA43-A450-454C-B408-E7B580830933
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 5 through 40 years with a diagnosis of mild, moderate, or severe persistent asthma who were prescribed either the preferred long-term control medication (inhaled corticosteroid) or an acceptable alternative treatment
Copyright
© 2010 American Medical Association.  All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
Although current guidelines recommend inhaled corticosteroids as the preferred pharmacological treatment for persistent asthma, other long-term control medications are acceptable alternatives. Long Acting-inhaled Beta2 Agonists (LABA) are recommended in combination with Inhaled Corticosteroids.
Clinical Recommendation Statement
A stepwise approach to therapy is recommended to maintain long-term control: 
Step 1: Mild Intermittent Asthma
• No daily medication needed
Step 2: Mild Persistent Asthma
• Preferred treatment: Low-dose inhaled corticosteroids (ICS)
• Alternative treatment: Cromolyn, leukotriene modifier, nedocromil, OR sustained-release theophylline
Step 3: Moderate Persistent Asthma
• Preferred treatment: Low-medium dose ICS + long-acting inhaled beta2-agonists (LABA)
• Alternative treatment: Increase medium-dose ICS OR low-medium dose ICS and either leukotriene modifier or theophylline
(If needed, may increase ICS within medium-dose range in either treatment)
Step 4: Severe Persistent Asthma
• Preferred treatment: High-dose ICS + LABA AND, if needed, corticosteroid tablets or syrup long-term
Studies comparing ICS to cromolyn, nedocromil, theophylline, or leukotriene receptor antagonists are limited, but available evidence shows that none of these long-term control medications appear to be as effective as ICS in improving asthma outcomes.
For quick relief for all patients, a short-acting bronchodilator is recommended as needed for symptoms. (NAEPP/NHLBI)
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health; July 1997. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed August 2002.
Reference
National Asthma Education and Prevention Program Expert Panel Report 2 Update: Guidelines for the diagnosis and management of asthma – update on selected topics 2002. National Heart, Lung, and Blood Institute, National Institutes of Health; August 2002. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed September 2002.
Definition
Initial Patient Population(s): Patient Age: Patients aged 5 through 40 years old at the beginning of the measurement period. Diagnosis Active: Patient has a documented diagnosis of asthma with mild, moderate, or severe persistent asthma. 
Encounter: At least 2 visits with the physician, physician's assistant, or nurse practitioner during the measurement period.
Definition
Denominator(s): All patients aged 5 through 40 years with a diagnosis of mild, moderate, or severe persistent asthma.
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Patients who were prescribed either the preferred long-term control medication (inhaled corticosteroid or inhaled corticosteroid with long-acting inhaled beta2-agonist) or an acceptable alternative treatment (leukotriene modifiers, cromolyn sodium, nedocromil sodium, or sustained-released methylaxanthines).
Definition
Denominator Exception(s): Documentation of patient reason(s) for not prescribing either the preferred long-term control medication (inhaled corticosteroid or inhaled corticosteroid with long-acting inhaled beta2-agonist) or an acceptable alternative treatment (leukotriene modifiers, cromolyn sodium, nedocromil sodium, or sustained-released methylaxanthines) (e.g. patient declined).
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