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  • Measure Summary
  • NQMC:010550
  • Oct 2015

Potentially harmful drug-disease interactions in the elderly: percentage of Medicare members 65 years of age and older who have evidence of an underlying disease, condition or health concern and who were dispensed an ambulatory prescription for a potentially harmful medication, concurrent with or after the diagnosis.

National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.
National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

This is the current release of the measure.

This measure updates previous versions:

  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
  • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.

Measure Hierarchy

HEDIS 2016: Health Plan Collection > Effectiveness of Care > Overuse/Appropriateness

Age Group

UMLS Concepts (what is this?)

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Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of Medicare members 65 years of age and older who have evidence of an underlying disease, condition or health concern and who were dispensed an ambulatory prescription for a potentially harmful medication, concurrent with or after the diagnosis.

Report each of the three rates separately and as a total rate.

  • A history of falls and a prescription for anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants
  • Dementia and a prescription for antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents
  • Chronic kidney disease and prescription for cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs
  • Total rate (the sum of the three numerators divided by the sum of the three denominators)

This measure summary represents the total rate.

Note: Members with more than one disease or condition may appear in the measure multiple times (i.e., in each indicator for which they qualify).

    Rationale

    Pharmacotherapy is an essential component of medical treatment for older patients, but medications are also responsible for many adverse events in this group. Almost 90 percent of people 65 and older take at least one medication, significantly more than any other age group (Agency for Healthcare Research and Quality [AHRQ], 1996). Patient safety is highly important to member health, especially patients who are at increased risk of adverse drug events due to coexisting conditions and polypharmacy. Adverse drug events have been linked to preventable problems in elderly patients, such as depression, constipation, falls, immobility, confusion and hip fractures. Thirty percent of elderly-patient hospital admissions may be linked to drug-related problems or toxic effects (Hanlon et al., 1997).

    Drug-disease interactions identified for reporting in this measure are based on the literature and on the key clinical expert consensus process by Beers that identified potentially inappropriate medication use in older adults with specific diagnoses or conditions. The National Committee for Quality Assurance's (NCQA's) medication management expert panel provided advice on the conditions and drugs to be included in this measure, based on the updated Beers list and a Canadian panel and significance of harm and impact on the older adult population (Fick et al., 2003).

    Evidence for Rationale

    Agency for Healthcare Research and Quality. Health care use in America-1996 Medical Expenditure Panel Survey Highlights. Rockville (MD): Agency for Healthcare Research and Quality; 1996.

    Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003 Dec 8-22;163(22):2716-24. PubMed External Web Site Policy

    Hanlon JT, Schmader KE, Koronkowski MJ, Weinberger M, Landsman PB, Samsa GP, Lewis IK. Adverse drug events in high risk older outpatients. J Am Geriatr Soc. 1997 Aug;45(8):945-8. PubMed External Web Site Policy

    National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

    Primary Health Components

    Medication safety; falls; hip fracture; dementia; chronic kidney disease; anticonvulsants; nonbenzodiazepine hypnotics; selective serotonin re-uptake inhibitors (SSRIs); antiemetics; antipsychotics; benzodiazepines; tricyclic antidepressants; H2 receptor antagonists; nonbenzodiazepine hypnotics; anticholinergic agents; cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs); nonasprin NSAIDs; elderly

    Denominator Description

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Medicare members age 67 years and older as of December 31 of the measurement year who had an accidental fall or hip fracture on or between January 1 of the year prior to the measurement year and December 1 of the measurement year
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Medicare members age 67 years and older as of December 31 of the measurement year with a diagnosis of dementia or a dispensed dementia medication on or between January 1 of the year prior to the measurement year and December 1 of the measurement year
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Medicare members age 67 years and older as of December 31 of the measurement year with chronic kidney disease as identified by a diagnosis of end-stage renal disease (ESRD), stage 4 chronic kidney disease or kidney transplant on or between January 1 of the year prior to the measurement year and December 1 of the measurement year

    See the related "Denominator Inclusions/Exclusions" field.

    Numerator Description

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Dispensed an ambulatory prescription for an anticonvulsant, nonbenzodiazepine hypnotic, selective serotonin re-uptake inhibitor (SSRI), or antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant on or between the Index Episode Start Date (IESD) and December 31 of the measurement year
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Dispensed an ambulatory prescription for an antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant or H2 receptor antagonist, nonbenzodiazepine hypnotic or anticholinergic agent on or between the IESD and December 31 of the measurement year
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Dispensed an ambulatory prescription for an NSAID or Cox-2 selective NSAID on or between the IESD and December 31 of the measurement year

    See the related "Numerator Inclusions/Exclusions" field.

    Type of Evidence Supporting the Criterion of Quality for the Measure

    • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
    • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

    Additional Information Supporting Need for the Measure

    • Prescription drug use by the elderly can often result in adverse drug events that contribute to hospitalization, increased duration of illness, nursing home placement, falls and fractures. Despite widely accepted medical consensus that certain drugs increase the risk of harm to the elderly (Fick et al., 2003), these drugs continue to be prescribed. Because older adults are more likely to take multiple medications for multiple conditions, they are also at higher risk of potentially harmful drug-disease interactions.
    • Health care costs linked to prescriptions of potentially inappropriate medications in the elderly average $7.2 billion a year (Fu et al., 2007).
    • Almost 40 percent of adults 65 and older report being on five or more medications (National Center for Health Statistics [NCHS], 2014).
    • Approximately 15 percent of adverse drug events occur in the elderly; 28 percent of hospitalizations of older adults are due to inappropriate use of medications (Pretorius et al., 2013; American Geriatrics Society [AGS], 2011).
    • Avoiding the use of high-risk drugs is an important, simple and effective strategy in reducing medication-related problems and adverse drug events in older adults (AGS, 2012).

    Evidence for Additional Information Supporting Need for the Measure

    American Geriatrics Society (AGS). American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. New York (NY): American Geriatrics Society (AGS); 2012.

    American Geriatrics Society (AGS). Medication management for older adults. New York (NY): American Geriatrics Society (AGS); 2011.

    Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003 Dec 8-22;163(22):2716-24. PubMed External Web Site Policy

    Fu AZ, Jiang JZ, Reeves JH, Fincham JE, Liu GG, Perri M 3rd. Potentially inappropriate medication use and healthcare expenditures in the US community-dwelling elderly. Med Care. 2007 May;45(5):472-6. PubMed External Web Site Policy

    National Center for Health Statistics. Health, United States, 2013: with special feature on prescription drugs. Hyattsville (MD): Centers for Disease Control and Prevention, National Center for Health Statistics; 2014 May. 497 p.

    National Committee for Quality Assurance (NCQA). The state of health care quality 2015. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. 205 p.

    Pretorius RW, Gataric G, Swedlund SK, Miller JR. Reducing the risk of adverse drug events in older adults. Am Fam Physician. 2013 Mar 1;87(5):331-6. PubMed External Web Site Policy

    Extent of Measure Testing

    All HEDIS measures undergo systematic assessment of face validity with review by measurement advisory panels, expert panels, a formal public comment process and approval by the National Committee for Quality Assurance's (NCQA's) Committee on Performance Measurement and Board of Directors. Where applicable, measures also are assessed for construct validity using the Pearson correlation test. All measures undergo formal reliability testing of the performance measure score using beta-binomial statistical analysis.

    Evidence for Extent of Measure Testing

    Rehm B. (Assistant Vice President, Performance Measurement, National Committee for Quality Assurance, Washington, DC). Personal communication. 2015 Mar 16.  1 p.

    State of Use

    Current routine use

    Current Use

    Accreditation

    Decision-making by businesses about health plan purchasing

    Decision-making by consumers about health plan/provider choice

    External oversight/Medicare

    Internal quality improvement

    Measurement Setting

    Ambulatory/Office-based Care

    Emergency Department

    Hospital Inpatient

    Hospital Outpatient

    Managed Care Plans

    Professionals Involved in Delivery of Health Services

    Pharmacists

    Physicians

    Least Aggregated Level of Services Delivery Addressed

    Single Health Care Delivery or Public Health Organizations

    Statement of Acceptable Minimum Sample Size

    Unspecified

    Target Population Age

    Age greater than or equal to 65 years

    Target Population Gender

    Either male or female

    National Quality Strategy Aim

    Better Care

    National Quality Strategy Priority

    Health and Well-being of Communities
    Making Care Safer
    Prevention and Treatment of Leading Causes of Mortality

    IOM Care Need

    Staying Healthy

    IOM Domain

    Effectiveness

    Safety

    Case Finding Period

    January 1 of the year prior to the measurement year to December 1 of the measurement year

    Denominator Sampling Frame

    Enrollees or beneficiaries

    Denominator (Index) Event or Characteristic

    Clinical Condition

    Encounter

    Institutionalization

    Patient/Individual (Consumer) Characteristic

    Denominator Time Window

    Time window brackets index event

    Denominator Inclusions/Exclusions

    Inclusions

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Medicare members age 67 years and older as of December 31 of the measurement year who had an accidental fall or hip fracture. Members with any of the following on or between January 1 of the year prior to the measurement year and December 1 of the measurement year meet criteria:
      • An accidental fall (Falls Value Set)
      • An outpatient visit (Outpatient Value Set), an observation visit (Observation Value Set), or an emergency department (ED) visit (ED Value Set) with a hip fracture (Hip Fractures Value Set)
      • An acute or nonacute inpatient discharge with a hip fracture (Hip Fractures Value Set). To identify acute and nonacute inpatient discharges:
        1. Identify acute and nonacute inpatient stays (Inpatient Stay Value Set).
        2. Identify the discharge date for the stay.
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Medicare members age 67 years and older as of December 31 of the measurement year who had a diagnosis of dementia (Dementia Value Set) or a dispensed dementia medication on or between January 1 of the year prior to the measurement year and December 1 of the measurement year. Refer to Table DDE-C in the original measure documentation for a list of prescriptions to identify members with dementia.
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Medicare members age 67 years and older as of December 31 of the measurement year with chronic kidney disease as identified by a diagnosis of end-stage renal disease (ESRD) (ESRD Value Set), stage 4 chronic kidney disease (CKD) (CKD Stage 4 Value Set) or kidney transplant (Kidney Transplant Value Set) on or between January 1 of the year prior to the measurement year and December 1 of the measurement year

    Note:

    • Members must have been enrolled during the measurement year and the year prior to the measurement year.
    • Allowable Gap: No more than one gap in enrollment of up to 45 days during each year of continuous enrollment.
    • Hip fractures are used as a proxy for identifying accidental falls (Rate 1).

    Exclusions

    • Rate 1: Exclude members with a diagnosis of psychosis (Psychosis Value Set), schizophrenia (Schizophrenia Value Set), bipolar disorder (Bipolar Disorder Value Set; Other Bipolar Disorder Value Set) or seizure disorder (Seizure Disorders Value Set) on or between January 1 of the year prior to the measurement year and December 1 of the measurement year.
    • Rate 2: Exclude members with a diagnosis of psychosis (Psychosis Value Set), schizophrenia (Schizophrenia Value Set), or bipolar disorder (Bipolar Disorder Value Set; Other Bipolar Disorder Value Set) on or between January 1 of the year prior to the measurement year and December 1 of the measurement year.

    Value Set Information
    Measure specifications reference value sets that must be used for HEDIS reporting. A value set is the complete set of codes used to identify the service(s) or condition(s) included in the measure. Refer to the NCQA Web site External Web Site Policy to purchase HEDIS Volume 2, which includes the Value Set Directory.

    Exclusions/Exceptions

    Medical factors addressed

    Numerator Inclusions/Exclusions

    Inclusions

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Dispensed an ambulatory prescription for an anticonvulsant, nonbenzodiazepine hypnotic, SSRI, or antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant on or between the Index Episode Start Date (IESD) and December 31 of the measurement year. Refer to Tables DDE-A and DDE-B in the original measure documentation for lists of potentially harmful drugs.
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Dispensed an ambulatory prescription for an antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant or H2 receptor antagonist, nonbenzodiazepine hypnotic or anticholinergic agent on or between the IESD and December 31 of the measurement year. Refer to Table DDE-B and Table DDE-D for lists of potentially harmful drugs.
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Dispensed an ambulatory prescription for an NSAID or Cox-2 selective NSAID on or between the IESD and December 31 of the measurement year. Refer to Table DDE-E in the original measure documentation for a list of Cox-2 selective NSAIDs and nonasprin NSAIDs.

    Note:

    • IESD: The earliest diagnosis, procedure or prescription between January 1 of the year prior to the measurement year and December 1 of the measurement year.
      • For an outpatient claim/encounter, the IESD is the date of service.
      • For an inpatient claim/encounter, the IESD is the discharge date.
      • For dispensed prescriptions, the IESD is the dispense date.
    • Total rate (the sum of the three numerators divided by the sum of the three denominators)

    Exclusions
    Unspecified

    Value Set Information
    Measure specifications reference value sets that must be used for HEDIS reporting. A value set is the complete set of codes used to identify the service(s) or condition(s) included in the measure. Refer to the NCQA Web site External Web Site Policy to purchase HEDIS Volume 2, which includes the Value Set Directory.

    Numerator Search Strategy

    Fixed time period or point in time

    Data Source

    Administrative clinical data

    Pharmacy data

    Type of Health State

    Does not apply to this measure

    Instruments Used and/or Associated with the Measure

    Unspecified

    Measure Specifies Disaggregation

    Measure is disaggregated into categories based on different definitions of the denominator and/or numerator

    Basis for Disaggregation

    This measure is disaggregated based on different definitions of the denominator and numerator. Report each of the three rates separately and as a combined rate.

    Denominators:

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Medicare members age 67 years and older as of December 31 of the measurement year who had an accidental fall or hip fracture
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Medicare members age 67 years and older as of December 31 of the measurement year who had a diagnosis of dementia or a dispensed dementia medication on or between January 1 of the year prior to the measurement year and December 1 of the measurement year
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Medicare members age 67 years and older as of December 31 of the measurement year with chronic kidney disease as identified by a diagnosis of end-stage renal disease (ESRD), stage 4 chronic kidney disease (CKD) or kidney transplant on or between January 1 of the year prior to the measurement year and December 1 of the measurement year

    Numerators:

    • Rate 1: Drug-disease interactions—history of falls and anticonvulsants, nonbenzodiazepine hypnotics, selective serotonin re-uptake inhibitors (SSRIs), antiemetics, antipsychotics, benzodiazepines or tricyclic antidepressants: Dispensed an ambulatory prescription for an anticonvulsant, nonbenzodiazepine hypnotic, SSRI, or antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant on or between the Index Episode Start Date (IESD) and December 31 of the measurement year.
    • Rate 2: Drug-disease interactions—dementia and antiemetics, antipsychotics, benzodiazepines, tricyclic antidepressants, H2 receptor antagonists, nonbenzodiazepine hypnotics or anticholinergic agents: Dispensed an ambulatory prescription for an antiemetic, antipsychotic, benzodiazepine or tricyclic antidepressant or H2 receptor antagonist, nonbenzodiazepine hypnotic or anticholinergic agent on or between the IESD and December 31 of the measurement year.
    • Rate 3: Drug-disease interactions—cyclo-oxygenase (Cox)-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) or nonasprin NSAIDs: Dispensed an ambulatory prescription for an NSAID or Cox-2 selective NSAID on or between the IESD and December 31 of the measurement year.

    Scoring

    Rate/Proportion

    Interpretation of Score

    Desired value is a lower score

    Allowance for Patient or Population Factors

    Unspecified

    Standard of Comparison

    External comparison at a point in, or interval of, time

    External comparison of time trends

    Internal time comparison

    Original Title

    Potentially harmful drug-disease interactions in the elderly (DDE).

    Measure Collection Name

    HEDIS 2016: Health Plan Collection

    Measure Set Name

    Effectiveness of Care

    Measure Subset Name

    Overuse/Appropriateness

    Submitter

    National Committee for Quality Assurance - Health Care Accreditation Organization

    Developer

    National Committee for Quality Assurance - Health Care Accreditation Organization

    Funding Source(s)

    Unspecified

    Composition of the Group that Developed the Measure

    National Committee for Quality Assurance's (NCQA's) Measurement Advisory Panels (MAPs) are composed of clinical and research experts with an understanding of quality performance measurement in the particular clinical content areas.

    Financial Disclosures/Other Potential Conflicts of Interest

    In order to fulfill National Committee for Quality Assurance's (NCQA's) mission and vision of improving health care quality through measurement, transparency and accountability, all participants in NCQA's expert panels are required to disclose potential conflicts of interest prior to their participation. The goal of this Conflict Policy is to ensure that decisions which impact development of NCQA's products and services are made as objectively as possible, without improper bias or influence.

    Adaptation

    This measure was not adapted from another source.

    Date of Most Current Version in NQMC

    2015 Oct

    Measure Maintenance

    Unspecified

    Date of Next Anticipated Revision

    Unspecified

    Measure Status

    This is the current release of the measure.

    This measure updates previous versions:

    • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.
    • National Committee for Quality Assurance (NCQA). HEDIS 2015: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2014. various p.

    Source(s)

    National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 1, narrative. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

    National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical specifications for health plans. Washington (DC): National Committee for Quality Assurance (NCQA); 2015. various p.

    Measure Availability

    Source available for purchase from the National Committee for Quality Measurement (NCQA) Web site External Web Site Policy.

    For more information, contact NCQA at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

    Companion Documents

    The following are available:

    • National Committee for Quality Assurance (NCQA). The state of health care quality 2015. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Oct. 205 p.
    • National Committee for Quality Assurance (NCQA). HEDIS 2016: Healthcare Effectiveness Data and Information Set. Vol. 2, technical update. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Oct 1. 12 p.

    For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

    NQMC Status

    This NQMC summary was completed by ECRI Institute on April 18, 2008. The information was verified by the measure developer on May 30, 2008.

    This NQMC summary was updated by ECRI Institute on March 20, 2009. The information was verified by the measure developer on May 29, 2009.

    This NQMC summary was updated by ECRI Institute on January 30, 2010 and on May 31, 2011.

    This NQMC summary was retrofitted into the new template on July 1, 2011.

    This NQMC summary was updated by ECRI Institute on September 14, 2012, April 30, 2013, January 23, 2014, February 11, 2015, and again on February 9, 2016.

    Copyright Statement

    This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

    Content adapted and reproduced with permission from the National Committee for Quality Assurance (NCQA). HEDIS® is a registered trademark of NCQA. HEDIS measures and specifications were developed by and are owned and copyrighted by NCQA. HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. NCQA disclaims all liability for use or accuracy of any coding contained in the specifications.

    Anyone desiring to use or reproduce the measure abstracts without modification for a non-commercial purpose may do so without obtaining any approval from NCQA. All commercial uses of the measure abstracts must be approved by NCQA and are subject to a license at the discretion of NCQA. To purchase copies of the full measures and specifications, which contain additional distribution and use restrictions, contact NCQA Customer Support at 888-275-7585 or visit www.ncqa.org/publications External Web Site Policy.

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