Vue.component('inr-overview', {
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'<h1 style="text-align: center">International Normalized Ratio Monitoring for Individuals on Warfarin (INR)</h1>' +
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'<h2>Description</h2>' +
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'<p>The percentage of individuals 18 years of age and older who had at least one 56-day interval of warfarin therapy and who received at least one international normalized ratio (INR) monitoring test during each 56-day interval with active warfarin therapy.</p>' +
'<p>A higher rate indicates better performance.</p>' +
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'<h2>Additional Information</h2>' +
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'<p><b>Intended Use</b></p>' +
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'<p>Performance measurement for health plans. This measure is specified for Qualified Health Plans in the Health Insurance Marketplace Quality Rating System.</p>' +
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'<el-row>' +
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'<p><b>Data Sources</b></p>' +
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'<p>Medical and pharmacy claims data.</p>' +
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'<el-row>' +
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'<p><b>Denominator</b></p>' +
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'<p>Individuals dispensed warfarin during the measurement year.</p>' +
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'<el-row>' +
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'<p><b>Exclusions</b></p>' +
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'<p>Individuals with INR home monitoring during the measurement year.</p>' +
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'<p><b>Numerator</b></p>' +
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'<p>Individuals who received at least one INR monitoring test or was hospitalized during each 56-day interval during the treatment period.</p>' +
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Vue.component('inr-ref-1', {
template:
'<el-popover placement="top-start" width="400" trigger="hover">' +
'<span>Holbrook, A., Schulman, S., Witt, D. M., Vandvik, P. O., Fish, J., Kovacs, M. J., . . . Guyatt, G. H. (2012). Evidence-based management of anticoagulant therapy: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2), e152S-e184S.</span>' +
'<sup slot="reference">1</sup>' +
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});
Vue.component('inr-ref-2', {
template:
'<el-popover placement="top-start" width="400" trigger="hover">' +
'<span>Anderson, J. L., Halperin, J. L., Albert, N. M., Bozkurt, B., Brindis, R. G., Curtis, L. H., . . . Shen, W. K. (2013). Management of patients with atrial fibrillation (Compilation of 2006 ACCF/AHA/ESC and 2011 ACCF/AHA/HRS recommendations): A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, 127, 1916-1926.</span>' +
'<sup slot="reference">2</sup>' +
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Vue.component('inr-ref-3', {
template:
'<el-popover placement="top-start" width="400" trigger="hover">' +
'<span>Rose, A. J., Miller, D. R., Ozonoff, A., Berlowitz, D. R., Ash, A. S., Zhao, S., . . . Hylek, E. M. (2013). Gaps in monitoring during oral anticoagulation: Insights into care transitions, monitoring barriers, and medication nonadherence. Chest, 143(3), 751-757.</span>' +
'<sup slot="reference">3</sup>' +
'</el-popover>'
});
Vue.component('inr-rationale', {
template:
'<div>' +
'<el-row id="inr-rationale" class="scrollspy">' +
'<h2>Rationale</h2>' +
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'<p></p>' +
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'<p>Last Update: 4 Oct 2019</p>' +
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Vue.component('inr-faqs', {
template:
'<div>' +
'<el-row id="inr-faqs" class="scrollspy">' +
'<h2>FAQs</h2>' +
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'<template slot="title"><span style="font-size: 15px; text-decoration: underline;">Are only paid, non-reversed prescription claims used when calculating the measure?</span></template>' +
"<p>No. Paid, reversed, and rejected prescription claims are all included when calculating the measure.</p>" +
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'<el-collapse-item name="2">' +
'<template slot="title"><span style="font-size: 15px; text-decoration: underline;">What happens if an individual stops and then restarts warfarin during the measurement year?</span></template>' +
'<p>Individuals can only have one treatment period during the measurement year. The treatment period begins with the earliest date of service (paid, reversed, or rejected claim) for warfarin during the measurement year, or index prescription start date (IPSD), and ends with the last day of supply for warfarin (date of service plus the days\' supply for the last prescription claim for warfarin, minus 1) during the measurement year. If the days\' supply extends beyond the end of the measurement year, the treatment period ends on December 31 of the measurement year.</p>' +
"<p>Gaps in prescription claims for warfarin can occur during the treatment period.</p>" +
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'<el-collapse-item name="3">' +
'<template slot="title"><span style="font-size: 15px; text-decoration: underline;">For the numerator, how are hospital stays identified?</span></template>' +
"<p>The Hospital Stay value set, which includes universal bill revenue codes, can be used for identifying hospital stays. The PQA value sets used in the QRS can be requested via the form on our website.</p>" +
'</el-collapse-item>' +
'<el-collapse-item name="4">' +
'<template slot="title"><span style="font-size: 15px; text-decoration: underline; height: 48px; line-height: 20px;">How is the length of the hospital stay determined? What happens if the individual is transferred or readmitted?</span></template>' +
"<p>The length of a hospital stay is determined from the admission and discharge dates. Hospital stays greater than 48 hours, or at least three days when hours are not available, meet the numerator criteria. The measure does not account for transfers or readmissions, so contiguous hospital stays should not be added together when determining the length of the hospital stay.</p>" +
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'<el-collapse-item name="5">' +
'<template slot="title"><span style="font-size: 15px; text-decoration: underline; height: 48px; line-height: 20px;">When a hospital stay spans more than one 56-day interval, to which interval(s) should the hospital stay be applied?</span></template>' +
"<p>Hospital stays are only applied to the 56-day interval in which the admission date falls. However, the entire hospital stay does not need to fall within the 56-day interval in which the admission date falls.</p>" +
'</el-collapse-item>' +
'<el-collapse-item name="6">' +
'<template slot="title"><span style="font-size: 15px; text-decoration: underline;">Why does the measure look for an INR test or hospital stay every 56 days during the treatment period?</span></template>' +
"<p>The measure's focus is on establishing a safe INR monitoring interval for the majority of patients on warfarin in the measure denominator. Warfarin has a narrow therapeutic range and requires regular monitoring through INR testing and dose adjustment for the patient to stay within the therapeutic range and avoid thromboembolism or bleeding complications.</p>" +
"<p>The 2012 American College of Chest Physicians guidelines for antithrombotic therapy and prevention of thrombosis recommend INR monitoring frequency of up to 12 weeks for patients with stable INRs.<inr-ref-1></inr-ref-1> The latest American College of Cardiology/American Heart Association guidelines continue to recommend INR monitoring on a monthly basis for patients with atrial fibrillation when anticoagulation is stable.<inr-ref-2></inr-ref-2> This measure adopts an evidence-based approach to INR monitoring for individuals on warfarin by using a 56-day interval that was found to be associated with significantly improved time in therapeutic window at both the patient and facility level.<inr-ref-3></inr-ref-3></p>" +
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Vue.component('inr', {
template:
'<div id="inr" class="search-filter inview">' +
'<inr-overview></inr-overview>' +
'<inr-rationale v-if="rationale"></inr-rationale>' +
'<inr-faqs v-if="faqs"></inr-faqs>' +
'<br><br><br><br>' +
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