1. Increase the percentage of patients with CHD or whose 10-year risk is greater than 20% who are on a statin. b. Percentage of patients with known CHD or CHD equivalent who are at their LDL goal of less than 100. a. Percentage of patients with or without known CHD or CHD equivalent who are on lipid-lowering medications who achieve the goal range for LDL-cholesterol for their risk group. Possible measures of accomplishing this aim: a. Percentage of patients with CHD or CHD equivalent for whom a diet evaluation has been completed. b. Percentage of patients with CHD or CHD equivalent with referral for individual diet instruction or class. c. Percentage of patients with CHD or CHD equivalent with documentation of receiving advice about an exercise program. d. Percentage of patients with CHD or CHD equivalent who are taking aspirin. b. Of patients on lipid-lowering medications, not achieving LDL goal with visits in the last month, the percentage who received intervention (e.g., change in dose, change in treatment, counseling). c. Of visits in the last month for patients on lipid-lowering medication, not achieving LDL goal, the percentage who received intervention (e.g., change in dose, change in treatment, counseling). a. Percentage of patients who initiate lipid-lowering therapy who remain on the therapy for 12 months. b. Percentage of patients who are on lipid-lowering therapy who remain on the therapy in 12-month intervals. Measurement Specifications Possible Success Measure # 3a Percentage of patients with diagnosed CHD or CHD equivalent who have had a diet evaluation. Population Definition All patients age 20 to 75 with diagnosed CHD or CHD equivalent, as defined below. Data of Interest
Numerator/Denominator Definitions ICD-9 codes in the previous 12 months: 410 to 414.9, V45.81 (coronary bypass), or V45.82 (angioplasty). Even if a patient has never been diagnosed with a lipid disorder, and/or is not on lipid-lowering treatment, they may be included if they are 20 to 75 years old and have diagnosed heart disease. Method/Source of Data Collection The preferred way to collect these data:• All patients 20 to 75 years old with diagnosed CHD or CHD equivalent could be identified. Each medical group would select at random 20 patients from this list for measurement each month. • Medical records of these 20 patients would be reviewed to determine if a diet evaluation has been done. An alternative way to collect the data if automated databases are not available for all patients to be measured:• All patients 20 to 75 years old with diagnosed CHD or CHD equivalent in the previous 12 months would be identified at the medical group using ICD-9 diagnostic codes from the previous 12 months. Each medical group would select at random 20 patients from this list for measurement each month. • Medical records of these 20 patients would be reviewed to determine if a diet evaluation has been done. Time Frame Pertaining to Data Collection Data on 20 patients are collected monthly and reported quarterly. Possible Success Measure # 4a Population Definition Data of Interest
Numerator/Denominator Definitions total cholesterol, HDL-cholesterol, triglycerides and calculated LDL-cholesterol after a 12-hour fasting period). Bile-Acid Sequestrant (BAS)
Niacin Statin
Method/Source of Data Collection with hypercholesterolemia (high LDL, normal trig and HDL), combined hyperlipidemia (high LDL and trig), hypertriglyceridemia and hypercholesterolemia (with isolated low HDL) who are on a lipid-lowering medication. done in the past 3 to 12 months. Data on 20 patients are collected monthly and reported quarterly.Time Frame Pertaining to Data Collection |