Assessment of Renal Function in Older Adults

Title

Assessment of Renal Function in Older Adults

Description

Percent of patients aged 65 years and older with a serum creatine on file at the pharmacy during the measurement year

A higher score is better

Rationale

Older adults have diminished renal function and many medications need to be adjusted based on renal excretion. This measure assesses whether the pharmacy has collected the laboratory information required to assess renal function.

Logic Model

This measure ensures the pharmacy has the salient information (serum creatine) to ensure patient specific dosing.

Level of Analysis

Pharmacy (Patient)

Data Source

Pharmacy Data

Denominator Statement

All patients aged 65 years or older that received a medication during the measurement year.

Denominator Calculation

1.     1. All individuals in the pharmacy

2.     2. All individuals aged 65 or older at the beginning of the measurement year

3.     3. Must have received a medication during the measurement year

4.     4. Remove an individual with exclusion criteria

Denominator Exclusions

Any patient only receiving an immunization at the pharmacy

Any non-human patients (e.g., cats, dogs, clinics, office-use, etc)

Denominator Exclusion Rationale

Many pharmacies may host immunization clinics and only interact with a patient during these visits. As immunizations do not need to be renally adjusted, assessment of renal function is not a required (valid) assessment.

Pharmacies may provide care to pets or other veterinarian needs, or for office-use. This patient profiles should be excluded from the measure calculation.

Numerator Statement

Individuals from the denominator with a serum creatine drawn during the measurement year

Numerator Calculation

1.     1. Identify number of individuals with serum creatine recorded

2.    2. Identify number of individuals with serum creatine updated during the measurement year

Seguridad Measure Specification Process

Data Stratification

The measure rate will be reported as a percent of patients within a single pharmacy.

If available and feasible, measure rate will be reported by type of pharmacy (e.g., health-system, community, specialty, mail-order, long-term care).

If available and feasible, measure rate will be reported by line of business (pharmacy Medicare rate, pharmacy Medicaid rate, pharmacy Commercial rate, and pharmacy uninsured rate).

Risk adjustment will be applied when available.

Value Sets

The value set Seguridad - CMP Immunizations will be used to support the exclusion criteria.

Future Iterations

Many pharmacy measures are designed as structure or process. Future goals of this concept include measures focused on appropriate dosing based on renal function and assessment of all patients.

Harmonization¹

Payors: N/A

Providers: N/A