High-Risk Medications in Older Adults
MEASURE DESCRIPTION
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).
A high-risk medication is identified by any one of the following:
A prescription for medications classified as high risk at any dose and for any duration.
A prescription for medications classified as high risk at any dose with greater than a 90 day supply.
A prescription for medications classified as high risk exceeding average daily dose criteria.
An order is identified by either a prescription order or a prescription refill.
Numerator
Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days.
a. At least two orders of high-risk medications from the same drug class.
b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days.
c. 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.
a. 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.
b. 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
Denominator
Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days.
a. At least two orders of high-risk medications from the same drug class.
b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days.
c. 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.
Total rate (the sum of the two previous numerators, deduplicated).
Denominator Exclusion
Exclude patients who are in hospice or palliative care for any part of the measurement period.
Scoring
CMS has removed the benchmark for this measure for 2024. Reporting this measure will earn 0 points, unless CMS develops benchmarks after submission.
RESOURCES
2024 eCQM Measure Specifications for 238
Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, 2023 update