PQA Endorses Two New Performance Measures

Springfield, VA - June 7, 2013 -  PQA announced the endorsement by its membership of two new performance measures during a vote on May 29th at the PQA Annual Meeting & Best Practices Forum.  The new measures are:  Adherence to Non-Warfarin Oral Anticoagulants Antipsychotic Use in Children Under 5 Years Old The measure, Adherence to Non-Warfarin Oral Anticoagulants, addresses the percentage of patients 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80 percent during the measurement period for the non-warfarin oral anticoagulants apixaban, dabigatran and rivaroxaban.  Adherence to all anticoagulants is important to decrease risk of stroke, pulmonary embolism and DVT.  This measure addresses an important safety concern because adherence to these new drugs cannot be monitored through a surrogate lab value, such as INR.  The half-life of these medications is short (in comparison to warfarin), so adherence to these non-warfarin anticoagulants may be more critical to monitor. PQA pilot testing with several large Medicare plans found that the measure is feasible, there is variation in performance among plans, and there is room for improvement.  PDC rates ranged from 58.4% to 85.6%.  Also, inclusion of patients over 75 years of age is important as all pivotal studies included this age group, this age group is included in the FDA-approved indications, and pilot testing demonstrated that these patients represent a substantial portion of members using the medications.  Testing showed that adherence rates for this age group were not lower than the population under age 75. The measure, Antipsychotic Use in Children Under Five Years Old, addresses the percentage of children under five years old that have received a prescription for an antipsychotic.  Research in Medicaid populations has shown that state-specific rates of any antipsychotic use in children were significantly increased in 45 states over a 5-year period.  There is growing public concern about this use of psychoactive drugs in children.  Studies indicate that the use of certain second-generation antipsychotic medications is associated with significant weight gain and other metabolic abnormalities in adolescent and pediatric patients.  Presently, there is no FDA approved indication for use of antipsychotics in children under 5 years of age; however, there is still significant use in this population. Using data from 45 state Medicaid programs, PQA pilot testing results showed considerable variation in state rates from 0% - 0.35%.  While this rate is low, it is still a significant percentage as the numerator reflects an event that should not occur (a never event).  Results from PQA testing show the measure is feasible for implementation by a Medicaid program.  Both measures can be calculated using prescription drug event data only.  For more information, please contact Woody Eisenberg MD, Senior Vice President, Performance Measurement and Strategic Alliances at weisenberg@pqaalliance.org. About PQA Established in 2006, PQA represents pharmacy providers, pharmacy benefit management companies, health plans, outcomes researchers, academicians, health systems, consumer advocates, employers, pharmaceutical research and manufacturing companies, health IT vendors, medication therapy management companies and other stakeholders committed to improving the quality of the medication-use system. PQA's mission is: To improve the quality of medication management and use across healthcare settings with the goal of improving patients' health through a collaborative process to develop and implement performance measures and recognize examples of exceptional pharmacy quality. The PQA provides a leadership role in identification and selection of metrics for evaluating the quality of the medication-use process, provides education on quality improvement, and connects pharmacists and other stakeholders to healthcare improvement initiatives that can have a positive impact on patient outcomes.   For more information about PQA, please visit www.PQAalliance.org or contact us at 703-690-1987. CONTACT: Woody Eisenberg,  Senior Vice President, Performance Measurement & Strategic Alliances Pharmacy Quality Alliance 703-690-1987