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CMS 156 - Use of High-Risk Medications in Older Adults

Updated: 05/20/2024|Views: 1578

CMS 156 / Quality ID #238

Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.

  1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.
  2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.
  3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).
Denominator: Patients 65 years and older at the end of the measurement period who had a visit during the measurement period.
  • Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
Denominator Exclusions: Exclude patients who are in hospice care for any part of the measurement period.
  • Hospice is documented under Hospice in History. These patients will be excluded from the denominator.

Exclude patients receiving palliative care for any part of the measurement period.

  • Palliative Care is documented under Problems with a Start Date.
Numerator 1:

Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days.

  •  At least two orders of high-risk medications from the same drug class.
  • At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days.
  • At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria.

Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days except for appropriate diagnoses.

  • Patients with two or more antipsychotic prescriptions ordered on different days, and who did not have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics.
  • Patients with two or more benzodiazepine prescriptions ordered on different days, and who did not have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines.

Rate 3:  Total rate (the sum of the two previous numerators, deduplicated).

  • High risk medications are prescribed under Medications.
Office Visit Documentation:

Once all steps have been completed, the measure will be added to the Quality Measures Report.

Measure type: Process
High Priority Measure: Yes
Telehealth Eligible: Yes