Anti-depressant Medication Management

Last updated: January 31, 2017

CMS Measure ID: CMS128v5
Version: 5
NQF Number: 0105
Measure Description:

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).

Initial Patient Population:

Patients 18 years of age and older with a visit during the measurement period who were dispensed antidepressant medications in the time within 270 days (9 months) prior to the measurement period through the first 90 days (3 months) of the measurement period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date

Numerator Statement:

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

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
National Quality Strategy Domain: Effective Clinical Care
Previous Version: Anti-depressant Medication Management
Improvement Notation:

Higher score indicates better quality

Guidance:

To identify new treatment episodes for major depression, there must be a 90-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the first dispensing event associated with the Index Episode Start Date (Index Prescription Start Date).

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

Release Notes

Header

  • ‚ÄčUpdated Copyright.

    Section: Copyright

    Source: Annual Update

  • Removed the definition for index episode start date and updated the description for index prescription start date to match the new timing requirements.

    Section: Definition

    Source: Measure Lead

  • Update the timing of the medication for the Denominator Exclusion to reflect 105 days instead of 90 days for a negative medication history to capture patients refilling prescriptions before their prior 90-day prescription is complete.

    Section: Denominator Exclusions

    Source: JIRA (CQM-1712)

  • Updated description and logic to reflect a change in the measure intent to include patients who were prescribed a new antidepressant medication, rather than patients who had a diagnosis of depression.

    Section: Description

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Updated description and logic to reflect a change in the measure intent to include patients who were prescribed a new antidepressant medication, rather than patients who had a diagnosis of depression.

    Section: Initial Population

    Source: Measure Lead

  • Updated Rationale.

    Section: Rationale

    Source: Measure Lead

  • Updated References.

    Section: Reference

    Source: Measure Lead

Logic

  • Update the timing of the medication for the Denominator Exclusion to reflect 105 days instead of 90 days for a negative medication history to capture patients refilling prescriptions before their prior 90-day prescription is complete.

    Section: Denominator Exclusions

    Source: JIRA (CQM-1712)

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Variables

    Source: QDM Standards

Value Set

  • Value set Antidepressant Medication (2.16.840.1.113883.3.464.1003.196.12.1213): Added 3 RXNORM codes (1607617, 616402, 1430122) and deleted 3 RXNORM codes (1098710, 309671, 309672).

    Section: None

    Source: None

  • Value set Major Depression (2.16.840.1.113883.3.464.1003.105.12.1007): Deleted 2 ICD9CM codes (298.0, 311). Added 4 SNOMEDCT codes (251000119105, 281000119103, 321717001, 450714000).

    Section: None

    Source: None

External Resources