Beta-Blocker Prescribed at Discharge (NQF 0160)

EMeasure Name Beta-Blocker Prescribed at Discharge EMeasure Id B1D48BE2-5C7C-4488-B5FA-F356337B9
Version number 1 Set Id 25FC6BA6-FCBC-45F0-B4F5-AAB14C76CB15
Available Date No information Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Oklahoma Foundation for Medical Quality
Endorsed by National Quality Forum
Description Acute myocardial infarction (AMI) patients who are prescribed a beta-blocker at hospital discharge
Copyright
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
Long-term use of beta-blockers for patients who have suffered an acute myocardial infarction can reduce mortality and morbidity. Studies have demonstrated that the use of beta-blockers is associated with about a 20% reduction in this risk (Yusuf, 1988), and there is evidence of effectiveness in broad populations of patients with AMI (Krumholz, 1998). National guidelines strongly recommend long-term beta-blocker therapy for the secondary prevention of subsequent cardiovascular events in patients discharged after AMI (Antman, 2004; Anderson, 2007; and Smith 2006).
Clinical Recommendation Statement
National guidelines strongly recommend long-term beta-blocker therapy for the secondary prevention of subsequent cardiovascular events in patients discharged after AMI
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction): developed in collaboration with the American College of Emergency Physicians, American College of Physicians, Society for Academic Emergency Medicine, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2007;50:e1–157.
Reference
Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). 2004.
Reference
Krumholz HM, Anderson JL, Bachelder BL, Fesmire FM, Fihn SD, Foody JM, et al. ACC/AHA 2008 performance measures for adults with ST-elevation and non–ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non–ST-Elevation Myocardial Infarction). J Am Coll Cardiol. 2008;52:2046 –99.
Reference
Krumholz HM, Radford MJ, Wang Y, Chen J, Heiat A, Marciniak TA. National use and effectiveness of beta-blockers for the treatment of elderly patients after acute myocardial infarction: National Cooperative Cardiovascular Project. JAMA. 1998;280:623-629.
Reference
Smith SC, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update. J Am Coll Cardiol. 2006;47:2130 –9. doi:10.1016/j.jacc.2006.04.026.
Reference
Yusuf S, Wittes J, Friedman L. Overview of results of randomized clinical trials in heart disease. I. Treatments following myocardial infarction. JAMA. 1988; 260(14):2088:2093.
Definition
Guidance
The measurement period is one calendar year but the reporting period is 3 months as a calendar quarter; Q1 = Jan – Mar, Q2 = Apr – Jun, Q3 = Jul – Sep, Q4 is Oct – Dec.
			
Patients for whom there are missing or inaccurate data (e.g., arrival time, medication administration, etc.) are considered to have failed the measure; the total number of patients with missing or erroneous (e.g., a time of 03:69 or a date of 10/26/2035) data (i.e., measure failures) must be reported with the results of the measure.
			
Exclusion element guidance: 

The exclusion for patients who are clinical trial participants is limited to patients participating in a clinical trial for acute myocardial infarction (AMI), ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (non-STEMI) or heart attack, the same conditions as covered by the measure. Other clinical trials are not valid reasons for exclusions.

Transfers to another hospital that is not part of the hospital's organization are excluded since care may have been delivered in the other setting.  The measure as specified for abstraction allowed determination of other hospital by hospital unique identifier. Transfers to those hospitals using the same hospital unique identifier are not considered transfers for the exclusion section of this measure, those using other facility numbers are considered exclusions.
		

Table of Contents


Population criteria

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012