National Quality Forum Endorses Measures to Improve Medication Safety and Quality

18 endorsed measures address use and management of medication.

(Washington, DC, August 17, 2009) — To improve the quality and safety of medication use in the United States, the National Quality Forum (NQF) endorsed 18 measures for managing over the counter and prescription medications. The 18 endorsed measures assess prescribing and use of appropriate medications and medication adherence, reconciliation, and monitoring. The measures are among the first to be endorsed for medication management and help to highlight gaps in measurement and quality improvement for medication use and adherence.

Nearly 90 percent of Medicare beneficiaries take prescription medicine and almost half use five or more different medications. Up to 40 percent of patients do not take their medications as prescribed, and an estimated 1.5 million preventable adverse drug events occur each year. Yet, there are few standards available to measure and improve the quality and safety of medication use and management.

“Medications offer relief and life-saving treatment to millions of people across the country each day, but more must be done to measure and improve the quality and safety of medication adherence and management,” said Janet Corrigan, NQF president and CEO. “These measures are a starting point to improve quality and lay the groundwork for additional measure development for continued improvement in medication management.”

The NQF-endorsed measures focus on measuring and improving adherence and management of medication for a range of conditions where medication non-adherance is prevalent and results in severe adverse outcomes. Conditions include diabetes, asthma, coronary artery disease, kidney disease, chronic obstructive pulmonary disease, and schizophrenia.

The endorsed measures for adherence measure things like adherence of antipsychotics among patients with schizophrenia, and medication possession for statin therapy for patients with coronary artery disease. Other measures focus on medication reconciliation and review by measuring the percentage of adults over 65 who had a medication review, or the percentage of discharged patients over 65 whose medications were reconciled.

A previously endorsed framework guided the endorsement of medication management measures in the areas of adherence and education; decision-making; prescribing; safe medication use; and system coordination and communication.

NQF’s steering committee on medication management was co-chaired by Harold Pincus, director of quality and outcomes research at New York Presbyterian Hospital and Health System, and Paul Conlon, Senior Vice President of Clinical Quality and Patient Safety at Trinity Health.

“These measures for medication management add some standardization and clarity to the field of medication management,” said Pincus. “NQF’s attention to this topic helps identify gaps in measurement and pushes the field toward more and better measures for quality improvement in medication management.”

NQF is a voluntary consensus standards-setting organization. Any party may request reconsideration of the recommendations, in whole or in part, by notifying NQF in writing via e-mail no later than September 15 (appeals@qualityforum.org). For an appeal to be considered, the notification e-mail must include information clearly demonstrating that the appellant has interests that are directly and materially affected by the NQF-endorsed recommendations and that the NQF decision has had (or will have) an adverse effect on those interests.

This work was conducted under a contract from the Centers for Medicare & Medicaid Services.

The mission of the National Quality Forum is to improve the quality of American healthcare by setting national priorities and goals for performance improvement, endorsing national consensus standards for measuring and publicly reporting on performance, and promoting the attainment of national goals through education and outreach programs. NQF, a non-profit organization (qualityforum.org) with diverse stakeholders across the public and private health sectors, was established in 1999 and is based in Washington, DC.