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Pharmacy Quality Alliance

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Phone: (703) 347-7963


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PQA Performance Measures


PQA Measure Development

PQA develops medication-use measures in areas such as medication safety, medication adherence and appropriateness.  PQA’s measure development process begins with identifying the high-priority areas for health care and gaps in existing performance measure sets. PQA focuses on the priorities identified through the National Priorities Partnership and aligns its activities with the National Quality Strategy.  A consensus-driven process is used to draft, test, refine and endorse high-priority measures of medication-use quality. (
Click here to view process for development and testing of performance measures.)

Guidance for PQA member organizations participating in the voting process is available (here) to provide a comprehensive overview of the PQA measure endorsement voting process and details about how member organizations can prepare for the vote, know who can participate in the voting, how to cast a vote, and when it is appropriate to abstain from a measure endorsement vote.

The following endorsed measures are reviewed regularly by the PQA Measure Update workgroup and are updated as needed.  For more information contact Julie Kuhle, Vice President, Measure Operations at jkuhle@pqaalliance.org.  Download a PDF of these Measures here.


PQA Performance Measures


Proportion of Days Covered (PDC)
Description
The percentage of patients 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement period.

Report a rate for each of the following:     
• Beta-blocker (BB)     
• Renin Angiotensin System (RAS) Antagonists     
• Calcium Channel Blocker (CCB)     
• Statin     
• Biguanide     
• Sulfonylurea     
• Thiazolidinedione     
• DiPeptidyl Peptidase (DPP)-IV Inhibitor     
• Diabetes Roll-up     
• Anti-retroviral (this measure has a threshold of 90% for at least 2 medications)


Antipsychotic Use in Children Under 5 Years Old
Description

The percentage of children under age 5 using antipsychotic medications during the measurement period.



Adherence to Non-Warfarin Oral Anticoagulants
Description

The percentage of patients 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement period for non-warfarin oral anticoagulants



Primary Medication Non-Adherence
Description
The percentage of prescriptions for chronic medications e-prescribed by a prescriber and not obtained by the patient in the following 30 days.  This rate measures the level of primary medication non-adherence across a population of patients.


Antipsychotic use in Persons with Dementia - MDS
Description

The percentage of long-stay nursing home residents with dementia who are persistently receiving an antipsychotic medication without evidence of a psychotic disorder or related condition. (Click to read more...)



Use of Benzodiazepine Sedative Hypnotic Medications in the Elderly
Description
The percent of individuals 65 years of age and older that received two or more prescription fills for any benzodiazepine sedative hypnotic for a cumulative period of more than 90 days.


Statin Use in Persons with Diabetes
Description
The percentage of patients ages 40 – 75 years who were dispensed a medication for diabetes that receive a statin medication.


Use of Opioids at High Dosage in Persons Without Cancer
Description
The proportion (XX out of 1,000) of individuals without cancer receiving a daily dosage of opioids greater than 120mg morphine equivalent dose (MED) for 90 consecutive days or longer.


Use of Opioids from Multiple Providers in Persons Without Cancer
Description
The proportion (XX out of 1,000) of individuals without cancer receiving prescriptions for opioids from four (4) or more prescribers AND four (4) or more pharmacies.


Use of Opioids at High Dosage and from Multiple Providers in Persons Without Cancer.
Description
The proportion (XX out of 1,000) of individuals without cancer receiving prescriptions for opioids greater than 120mg morphine equivalent dose (MED) for 90 consecutive days or longer, AND who received opioid prescriptions from four (4) or more prescribers AND four (4) or more pharmacies.


Adherence to Long-Acting Inhaled Bronchodilator Agents in COPD Patients
Description
The percentage of patients with Chronic Obstructive Pulmonary Disease (COPD) who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement period for: Long-acting inhaled bronchodilator agents.


Concurrent Use of Opioids and Benzodiazepines
Description
This measure examines the percentage of individuals 18 years and older with concurrent use of prescription opioids and benzodiazepines. The denominator includes individuals 18 years and older by the first day of the measurement year with 2 or more prescription claims for opioids filled on 2 or more separate days, for which the sum of the days supply is 15 or more days during the measurement period. Patients in hospice care and those with a cancer diagnosis are excluded. The numerator includes individuals from the denominator with 2 or more prescription claims for benzodiazepines filled on 2 or more separate days, and concurrent use of opioids and benzodiazepines for 30 or more cumulative days. 


Adherence to Non-Infused Disease Modifying Agents Used to Treat Multiple Sclerosis
Description
The percentage of patients 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80% during the measurement period for medications treating multiple sclerosis (MS).


Treatment of Chronic Hepatitis C: Completion of Therapy
Description

The percentage of patients 18 years and older who initiated antiviral therapy during the measurement year for treatment of chronic Hepatitis C, and who completed the minimum intended duration of therapy with no significant gap(s) in therapy. 



Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults
Description

This measure evaluates the percentage of older adults with concurrent use of 3 or more unique central nervous system (CNS)-active medications.



Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults
Description

This measure evaluates the percentage of older adults with concurrent use of 2 or more unique anticholinergic medications. 



Diabetes Medication Dosing (DOS)
Description
The percentage of patients who were dispensed a dose higher than the daily recommended dose for the following therapeutic categories of oral hypoglycemics: biguanides, sulfonlyureas, thiazolidinediones and DPP-IV inhibitors.

Report each of the following rates separately:     
• Dosing for Biguanides     
• Dosing for Sulfonylureas     
• Dosing for Thiazolidinediones     
• Dosing for DPP-IV Inhibitors


Medication Therapy for Persons with Asthma
Description
The percentage of patients with asthma who were dispensed more than 3 canisters of a short-acting beta2 agonist inhaler over a 90-day period and who did not receive controller therapy during the same 90-day period. Two rates are reported.

• Suboptimal Control. The percentage of patients with persistent asthma who were dispensed more than 3 canisters of a short-acting beta2 agonist inhaler during the same 90-day period.

• Absence of Controller Therapy. The percentage of patients with asthma during the measurement period who were dispensed more than 3 canisters of short acting beta2 agonist inhalers over a 90-day period and who did not receive controller therapy during the same 90-day period.


Use of High-Risk Medications in the Elderly (HRM)
Description
The percentage of patients 65 years of age and older who received two or more prescription fills for a high-risk medication during the measurement period. Read report


Drug-Drug Interactions
Description
The percentage of patients who received a prescription for a target medication during the measurement period and who were dispensed a concurrent prescription for a precipitant medication.


Cholesterol Management in Coronary Artery Disease
Description
The percentage of adult patients diagnosed with coronary artery disease that received at least one prescription for a HMG-CoA reductase inhibitor (i.e., statin) medication during the measurement period.


Completion Rate for Comprehensive Medication Review
Description
The percentage of prescription drug plan members who met eligibility criteria for medication therapy management (MTM) services and who received a comprehensive medication review (CMR) during the eligibility period.


Antipsychotic Use in Persons with Dementia
Description
The percentage of individuals (65 years and older) with dementia who are receiving an antipsychotic medication without evidence of a psychotic disorder or related condition. 



 
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