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Use of High-Risk Medications in the Elderly (HRM)

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Description

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The percentage of individuals ≥65 years of age who received ≥2 prescription claims for a high-risk medication during the measurement year.

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A lower rate indicates better performance.

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Additional Information

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Intended Use

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Performance measurement for health plans.

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Data Sources

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Prescription claims data.

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Denominator

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Individuals aged 65 years and older as of the first day of the measurement year.

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Exclusions

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Hospice.

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Numerator

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Individuals from the denominator with 2 or more prescription claims on different dates of service for the same high-risk medication during the measurement year.

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FAQs

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PQA's Measure Update Panel (MUP) completed a review of the HRM measure in February of 2019. They voted to recommend several potential changes based on the recently published 2019 AGS Beers Criteria. In April, the Quality Metrics Expert Panel (QMEP) reviewed the MUP's recommendations and voted to approve the proposed changes. These changes to the specifications and NDC lists will not be available until the release of the 2020 PQA measure specifications in February of 2020 at the earliest (for measurement year 2019).

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To translate the Beers Criteria recommendations for use in this quality measure, PQA uses the following guiding principles to determine which medication classes are included:

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  • Include only medications listed in Table 2: 2015 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
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  • Include only prescription medications.
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  • Include only medications where the AGS Recommendation indicates "avoid" and the AGS Rationale does not include "avoid for" caveats that cannot be identified from prescription drug claims data.
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  • Include medications with caveats only if they can be measured efficiently and reliably from prescription drug claims data.
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  • If including a medication in the measure would likely result in the increased use of another potentially harmful medication that is not included in the measure, an exception to these guiding principles may be warranted to reduce this unintended consequence.
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Since the benzodiazepines have caveats (may be appropriate for seizure disorders, rapid eye movement sleep disorders, benzodiazepine withdrawal, ethanol withdrawal, severe generalized anxiety disorder, and periprocedural anesthesia), they are not included in the measure.

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', data: function() { return { active: active } } }); Vue.component('hrm', { template: '
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