Use of Appropriate Medications for Asthma (NQF 0036)

eMeasure Name Use of Appropriate Medications for Asthma eMeasure Id 2B547A15-6BF5-494C-80DC-84C8B11F2E58
Version number 1 eMeasure Set Id FB89F629-47A8-427C-8B54-107EC12FF23C
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward National Committee for Quality Assurance
Endorsed by National Quality Forum
Description The percentage of patients 5-50 years of age during the measurement year who were identified as having persistent asthma and were appropriately prescribed medication during the measurement year.
Copyright
© National Committee for Quality Assurance. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
Stratified by (i) age: 4-10,  (ii) age: 11-49, (iii) 4-49, where the total is the sum of the two numerators divided by the sum of the two denominators
Risk Adjustment
None
Data Aggregation
Rationale
This measure assesses the appropriate and timely use of medications for long-term control of asthma symptoms and offers meaningful and actionable information to health care providers and consumers. Asthma is the most common chronic childhood disease, affecting an estimated 6.2 million children and resulting in more than 6.5 million office visits, 500,000 hospitalizations, 1.51 million nonemergency outpatient department visits and 1.81 million ER visits for children and adults. In 1998, over $10 billion was spent on related medical expenditures in the United States. The financial and disease burden can be alleviated if patients have appropriate medications and medical management. This measure facilitates efforts toward effective disease management and prevention of traumatic outcomes.
Clinical Recommendation Statement
The US DHHS National Asthma Education Program Expert Panel Report-2 recommends inhaled corticosteroids over other long-term control medications in improving asthma outcomes, with the acknowledgement of a potential but small risk of adverse events with use of inhaled corticosteroids. Bronchodilators (e.g., beta2-adrenergic agonists, methylxanthines) act to relieve the symptoms of the disease during acute events, but do not lead to long-term improvement. Studies cited by the Expert Panel Report 2002 Update demonstrate inhaled corticosteroids improve asthma control compared to as-needed beta2-agonists without any other long-term control medication. Therefore, disease management relies on the use of combination therapy including anti-inflammatory medications to ensure clinical improvement of patient care.
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
National Asthma Education Program, Expert Panel Report. Guidelines for the diagnosis and management of asthma-Updated on Selected Topics 2002. Bethesda, MD: U.S. Department of Health and Human Services; 2002. No. 97-4051.
Definition
Initial Patient Population(s): All patients 5 to 50 years of age during the measurement period
Definition
Denominator(s): Patients in the initial population with a diagnosis of persistent asthma. There are several ways to determine a diagnosis of persistent asthma using at least one of the following criteria in both the measurement period and the 12 months prior to the measurement period. The criteria do not need to be the same across both periods: 
1) an emergency department (ED) visit or acute inpatient encounter, with a diagnosis of asthma 
2) at least four outpatient encounters and at least two asthma medications, or 
3) at least 4 asthmatic medications (other than leukotriene modifiers), or 
4)four counts of leukotriene modifiers with a diagnosis of asthma 
This measure stratifies the population as follows: 
Population 1: All patients 5 to 11 years of age during the measurement period
Population 2: all patients 12to 18 years of age during the measurement period 
Population 3: all patients 19 to 50 years of age during the measurement period
Definition
Denominator Exception(s): N/A
Definition
Numerator(s): The number of patients dispensed at least one prescription for a preferred asthma therapy during the measurement year
Definition
Denominator Exclusion(s): Exclude all patients diagnosed with emphysema, chronic obstructive pulmonary disease (COPD), cystic fibrosis or acute respiratory failure during the measurement period
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

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Data criteria (QDM Data Elements)

Supplemental Data Elements




Measure set CLINICAL QUALITY MEASURE SET 2011-2012