Use of High-Risk Medications in the Elderly

Last updated: May 18, 2016

CMS Measure ID: CMS156v3
Version: 3
NQF Number: 0022
Measure Description:

Percentage of patients 66 years of age and older who were ordered high-risk medications. Two rates are reported.

  1. Percentage of patients who were ordered at least one high-risk medication.
  2. Percentage of patients who were ordered at least two different high-risk medications.
Initial Patient Population:

Patients 66 years and older who had a visit during the measurement period

Denominator Statement:

Equals initial patient population

Denominator Exclusions:

None

Numerator Statement:

Numerator 1: Patients with an order for at least one high-risk medication during the measurement period.

Numerator 2: Patients with an order for at least two different high-risk medications during the measurement period.

Numerator Exclusions:

Not applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
National Quality Strategy Domain: Patient Safety
Next Version: Use of High-Risk Medications in the Elderly
Measure Score: Proportion
Score Type: Process
Improvement Notation:

Lower score indicates better quality

Guidance:

The intent of Numerator 1 of the measure is to assess if the patient has been prescribed at least one high-risk medication. The intent of Numerator 2 of the measure is to assess if the patient has been prescribed at least two different high-risk medications.

CUMULATIVE MEDICATION DURATION is an individual’s total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.

To determine the cumulative medication duration, determine first the number of the Medication Days for each prescription in the period: the number of doses divided by the dose frequency per day. Then add the Medication Days for each prescription without counting any days between the prescriptions.

For example, there is an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.

Specifications

External Resources