Management of attention deficit hyperactivity disorder (ADHD) in primary care for school age children and adolescents (NQF 0107)

eMeasure Name Management of attention deficit hyperactivity disorder (ADHD) in primary care for school age children and adolescents eMeasure Id DAD6B3EC-6BDB-43EA-A6B1-0D2DDC72254D
Version number 1 eMeasure Set Id 95598DD3-A4E2-4C31-8375-5E1360B5BAC6
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Institute for Clinical Systems Improvement
Endorsed by National Quality Forum
Description Percentage of patients treated psychostimulant with medication for the diagnosis of ADHD whose medical record contains documentation of a follow-up visit at least twice a year.
Copyright
Measure scoring Rate (percent)
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
Medication management for ADHD is associated with improved academic performance and short-term symptom relief.
Clinical Recommendation Statement
Medication is an effective treatment for ADHD. Medication is superior to non-pharmacological interventions when delivered alone. The decision to use medication should be made in conjunction with parents following a thorough discussion of expected benefits and potential risks. Factors such as child's age, severity of symptoms, and presence of comorbidity should also be considered and may involve decision-making regarding choice of medication. Once patient is stable, clinic visits should occur every three to six months, depending on individual case; there should be more frequent visits for patients with significant comorbidity.
Improvement notation
Improve the primary care use of FDA-approved ADHD medications with indications for management of patients with ADHD.
Measurement duration
12 month(s)
Reference
Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of attention deficit hyperactivity disorder in primary care for school age children and adolescents, 8th ed. Bloomington MN: Institute for Clinical Systems Improvement (ICSI), March 2010; p.4
Reference
Goldman LS, Genel M, Bezman RJ, et al. Diagnosis and treatment of attention deficit hyperactivity disorder in children and adolescents. JAMA 1998; 279:1100-07
Reference
MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention deficit hyperactivity disorder. Arch Gen Psychiatry 1999; 56:1073-86
Reference
Faraone SV, Wilens T. Does stimulant treatment lead to substance use disorders? J Clin Psychiatry 2003; 64:9-13
Reference
American Academy of Pediatrics Committee on Quality Improvement Subcommittee on Attention Deficit Hyperactivity Disorder. Clinical Practice Guideline: diagnosis and evaluation of the child with attention deficit hyperactivity disorder. Pediatr 2000; 105:1158-70
Reference
Dulcan M. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1997; 36(10 Supplement):0855-1215
Reference
National Institutes of Health Consensus Statement. Diagnosis and treatment of attention deficit hyperactivity disorder (ADHD). 1998; 16:1-37
Definition
Care Plan: Each encounter should have a plan of management or care plan. At the minimum this should include a discussion regarding medication dosing and plan for next visit. In addition, the care plan may include school interventions, behavioral health and community resources.
Definition
Initial Patient Population(s): All children and adolescents ages 5-18 diagnosed with attention deficit hyperactivity disorder (ADHD) and an outpatient encounter.
Definition
Denominator(s): Number of patients with ADHD on psychostimulant medication.
Definition
Denominator Exclusion(s): N/A
Definition
Numerator(s): Number of patients with ADHD on psychostimulant medication with at least two visits a year addressing height, weight, medication review, assessment of school progress and a plan of care for ADHD.
Definition
Denominator Exception(s): N/A
Guidance
The numerator for this measure requires that the patient have each of six items addressed during at least two office visits during the measurement period. The six items include: measurement of height, measurement of weight, review of psychostimulant medication with the patient, parent or care giver, assessment of school progress, creation of a plan of care related to ADHD and active use of psychostimulants. The time interval between these two office visits must be at least one month to allow for evaluation of improvement.
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