Medication SafetyPQA Medication Safety MeasuresPatient safety is addressed through several measures. The Drug-Drug Interactions measure was developed by PQA to identify patients who were concurrently receiving two drugs for which serious adverse effects have been reported or may be expected based on known pharmacology of the drugs involved, and co-prescription has an unfavorable balance of benefits and harms for many, if not most, individuals, particularly in light of available pharmacologic and nonpharmacologic alternatives. The measure, Antipsychotic Use in Persons with Dementia, was developed to identify the percentage of individuals with dementia who are receiving an antipsychotic medication without evidence of a psychotic disorder or related condition. This measure was also adapted for the long-term care setting using MDS data.
Three measures address patient safety in older adults. The Use of High-Risk Medications in the Elderly (HRM) measure is adapted from a Healthcare Effectiveness Data and Information Set (HEDIS®) measure, which assesses medication management in the elderly to prevent the harms associated with certain medications for this population. Two measures that address polypharmacy in older adults, like the HRM measure, are based on the American Geriatric Society Beers Criteria. Use of multiple anticholinergics in older adults is associated with an increased risk of cognitive decline and use of multiple CNS active medications in older adults is associated with an increased risk of falls.
Eight measures address high-risk use of prescription opioids in persons without cancer. Four measures evaluate use of opioids with benzodiazepines, at high dosage (≥90 MME/day), or from multiple prescribers and pharmacies, which is associated with an increased risk of potentially fatal opioid overdose. Three initial opioid prescribing measures evaluate new prescriptions at high dosage (≥50 morphine milligram equivalents per day), for long duration (>7 cumulative days’ supply), or for long-acting or extended release opioids, which is associated with an increased risk of chronic use, misuse, and in some cases, overdose. One measure evaluates annual drug monitoring among individuals prescribed long-term opioid therapy, excluding those with a cancer diagnosis or in hospice care.
* Updated March 17, 2021 |