eMeasure Title Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
eMeasure Identifier
(Measure Authoring Tool)
138 eMeasure Version number 1
NQF Number 0028 GUID e35791df-5b25-41bb-b260-673337bc44a8
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Measure Developer American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Endorsed By National Quality Forum
Description
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user
Copyright
Copyright 2012 American Medical Association. All Rights Reserved.
Disclaimer
Physician Performance Measures (Measures) and related data specifications have been developed by the American Medical Association (AMA) - convened Physician Consortium for Performance Improvement(R) (the PCPI[TM]). These Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measures require a license agreement between the user and the AMA, (on behalf of the PCPI). Neither the AMA, PCPI nor its members shall be responsible for any use of the Measures. 

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CPT(R) contained in the Measure specifications is copyright 2004-2011 American Medical Association. LOINC(R) copyright 2004-2011 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2011 International Health Terminology Standards Development Organisation. ICD-10 copyright 2011 World Health Organization. All Rights Reserved.

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Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
There is good evidence that tobacco screening and brief cessation intervention (including counseling and pharmacotherapy) in the primary care setting is successful in helping tobacco users quit. Tobacco users who are able to stop smoking lower their risk for heart disease, lung disease, and stroke.
Clinical Recommendation Statement
The USPSTF strongly recommends that clinicians screen all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products. (A Recommendation) (USPSTF, 2003)

During new patient encounters and at least annually, patients in general and mental healthcare settings should be screened for at-risk drinking, alcohol use problems and illnesses, and any tobacco use. (NQF, 2007)
All patients should be asked if they use tobacco and should have their tobacco-use status documented on a regular basis. Evidence has shown that clinic screening systems, such as expanding the vital signs to include tobacco status or the use of other reminder systems such as chart stickers or computer prompts, significantly increase rates of clinician intervention. (Strength of Evidence = A) (U.S. Department of Health & Human Services-Public Health Service, 2008)

All physicians should strongly advise every patient who smokes to quit because evidence shows that physician advice to quit smoking increases abstinence rates. (Strength of Evidence = A) (U.S. Department of Health & Human Services-Public Health Service, 2008)

Minimal interventions lasting less than 3 minutes increase overall tobacco abstinence rates. Every tobacco user should be offered at least a minimal intervention whether or not he or she is referred to an intensive intervention. (Strength of Evidence = A) (U.S. Department of Health & Human Services-Public Health Service, 2008)
Improvement Notation
Higher score indicates better quality
Reference
U. S. Preventive Services Task Force. Counseling to prevent tobacco use and tobacco-related diseases: Recommendation statement. November 2003. Agency for Healthcare Research and Quality. Rockville, MD. Available at: http://www.ahrq.gov/clinic/3rduspstf/tobaccounrs/htm. Accessed November 2007.
Reference
National Quality Forum. National voluntary consensus standards for the treatment of substance use conditions: evidence-based treatment practices. Washington, DC: National Quality Forum; 2007.
Reference
Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.
Definition
Tobacco Use – Includes any type of tobacco
Cessation Counseling Intervention – Includes brief counseling (3 minutes or less), and/or pharmacotherapy
Guidance
If tobacco use status of a patient is unknown, the patient cannot be counted in the numerator and should be considered a measure failure.  Instances where tobacco use status of "unknown" is recorded include: 1) the patient was not screened; or 2) the patient was screened and the patient (or caregiver) was unable to provide a definitive answer.  If tobacco use status of “unknown” is recorded but the patient has an allowable medical exception, then the patient should be removed from the denominator of the measure and reported as a valid exception.
Transmission Format
TBD
Initial Patient Population
All patients aged 18 years and older
Denominator
Equals Initial Patient Population
Denominator Exclusions
None
Numerator
Patients who were screened for tobacco use at least once within 24 months AND who received tobacco cessation counseling intervention if identified as a tobacco user
Numerator Exclusions
Not Applicable
Denominator Exceptions
Documentation of medical reason(s) for not screening for tobacco use (eg, limited life expectancy, other medical reason)
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
None