Thank you for your inquiry regarding STK-2 CMS104 Discharged on Antithrombotic Therapy. The initial patient population includes patients 18 years of age or older. Initial population: Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period The logic within the initial population states: TJC.Non Elective Encounter with Age ["Encounter, Performed": "Nonelective Inpatient Encounter"] NonElectiveEncounter   where AgeInYearsAt(date from start of NonElectiveEncounter.relevantPeriod) >= 18     and NonElectiveEncounter.relevantPeriod ends during day of "Measurement Period" You may need to work with your EHR vendor and/or quality team to ensure that the proper population is being flagged for the measure.

We’ve encountered several patients under 18 years old flagged for this measure due to conditions like ASCVD linked to hemorrhagic stroke at birth (e.g., associated with cerebral palsy). While these patients may be disabled, they are not clinically appropriate for statin therapy. Our pharmacy teams have noted that statins are generally not indicated for children under 10 years old. While we can document a ‘medical reason’ for not prescribing statins, it seems the measure’s age criteria may not fully align with clinical practice. Could you clarify if there is any existing guidance from the measure owner regarding the interpretation of age within this measure?