Medication Safety

PQA Medication Safety Measures


Patient 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. The Antipsychotic Use in Children under 5 Years measure addresses the use of antipsychotic medications in a population where there are no approved indications for their use.

  • Drug-Drug Interactions (2017 Update) (DDI-2017)
  • Antipsychotic Use in Persons with Dementia (APD) (NQF #2111)
  • Antipsychotic Use in Persons with Dementia: MDS (APD-MDS)
  • Antipsychotic Use in Children under 5 Years (APC)

Four 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. The measure, Use of Benzodiazepine Sedative Hypnotic Medications in the Elderly, was developed to address a gap in the HRM measure. Two measures that address polypharmacy in older adults, like the HRM measure, are based on the American Geriatric Society 2015 Updated 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.

  • Use of High-Risk Medications in the Elderly (2017 Update) (HRM-2017)
  • Use of Benzodiazepine Sedative Hypnotic Medications in the Elderly (BSH)
  • Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (POLY-ACH)
  • Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults (POLY-CNS)

Four measures address high-risk use of prescription opioids in persons without cancer. Use of opioids with benzodiazepines, at high dosage, or from multiple prescribers and pharmacies are associated with an increased risk of potentially fatal opioid overdose.

  • Concurrent Use of Opioids and Benzodiazepines (COB)
  • Use of Opioids at High Dosage in Persons Without Cancer (OHD) (NQF #2940)
  • Use of Opioids from Multiple Providers in Persons Without Cancer (OMP) (NQF #2950)
  • Use of Opioids at High Dosage and from Multiple Providers in Persons Without Cancer (OHDMP) (NQF #2951)
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* Update: August 28, 2018