Uploaded image for project: 'eCQM Issue Tracker'
  1. eCQM Issue Tracker
  2. CQM-4936

Add clarity to the header and definition names to identify continuous treatment

    XMLWordPrintable

Details

    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:
      ​CMS128: Anti-depressant Medication Management:
      Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported.
      a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks).
      b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).

      Description of Issue:
      ​The header descriptions for Numerators 1 and 2 are "at least 84 days (12 weeks) of continuous treatment during  the 114-day period following the Index Prescription Start Date" and "at  least 180 days (6 months) of continuous treatment during the 231-day  period following the Index Prescription Start Date". Based on the current language, it is unclear to implementers whether the day of Index Prescription Start Date (IPSD) should be counted.
       
      To clarify that the continuous treatment period should include the IPSD, the measure developer proposes updating the header descriptions and logic definition names for Numerators 1 and 2.
       
      This does not impact the logic content as the current logic already includes the IPSD when calculating continuous treatment satisfaction; however, the propose solution includes recommended definition changes to align with the header changes.

      Proposed Solution:
      ​Before

      //Header: Definition
      The "continuous treatment" described in this measure allows for gaps in medication treatment up to a total 30 days during the 114-day period (numerator 1) or 51 days during the 231-day period (numerator 2). Gaps can include either gaps used to change medication, or treatment gaps to refill the same medication.

      //Header: Numerator
      Numerator 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment during the 114-day period following the Index Prescription Start Date.

      Numerator 2: Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.

      //Logic

      define "Antidepressant Medication Period In 114 Days After Initial Dispense":
      ....

      define "Antidepressant Medication Period In 231 Days After Initial Dispense":
      ......

      define "Cumulative Medication Duration Greater Than or Equal to 180 Days":
        "Cumulative Medication Duration"("Antidepressant Medication Period In 231 Days After Initial Dispense")>= 180

      define "Cumulative Medication Duration Greater Than or Equal to 84 Days":
        "Cumulative Medication Duration"("Antidepressant Medication Period In 114 Days After Initial Dispense")>= 84

      After

      //Header: Definition
      The "continuous treatment" described in this measure allows for gaps in medication treatment up to a total 31 days during the 115-day period (numerator 1) or 52 days during the 232-day period (numerator 2). Gaps can include either gaps used to change medication, or treatment gaps to refill the same medication.

      //Header: Numerator
      Numerator 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment beginning on the IPSD through 114 days after the IPSD (115 total days).

      Numerator 2: Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment beginning on the IPSD through 231 days after the IPSD (232 total days).

      //Logic

      define "Antidepressant Medication Period During IPSD or 114 Days After IPSD":
      ...

      define "Antidepressant Medication Period During IPSD or 231 Days After IPSD":
      ...

      define "Cumulative Medication Duration Greater Than or Equal to 180 Days":
        "CumulativeDuration"("Antidepressant Medication Period During IPSD or 231 Days After IPSD")>= 180

      define "Cumulative Medication Duration Greater Than or Equal to 84 Days":
        "CumulativeDuration"("Antidepressant Medication Period During IPSD or 114 Days After IPSD")>= 84

      Rationale for Change:
      ​The goal of this change is to provide clarification on the continuous treatment requirement.

      Attachments

        Activity

          People

            khancock Mathematica EC eCQM Team
            khancock Mathematica EC eCQM Team
            Votes:
            0 Vote for this issue
            Watchers:
            3 Start watching this issue

            Dates

              Created:
              Updated: