Improving Diabetes Safety

Title

Improving Diabetes Safety

Description

Percent of patients at risk for glycemia receiving bolus insulin receive glucagon.

A higher score is better

Rationale

Many patients with diabetes are at risk for hypoglycemia, which can cause hospitalizations or death. Individuals using insulin, particularly meal-time, or bolus, are at increased risk for hypoglycemia.

Logic Model

This measure ensures patients at increased risk for hypoglycemia have appropriate treatment available.

Level of Analysis

Pharmacy (Patient)

Data Source

Pharmacy Data

Denominator Statement

Patient at risk for hypoglycemia due to bolus insulin use.

Denominator Calculation

1.     1. All individuals in the pharmacy

2.    2. All individuals prescribed a bolus insulin

3.    3. Exclude non-human patients.

Denominator Exclusions

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

Denominator Exclusion Rationale

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

Patients from the denominator with glucagon.

Numerator Calculation

1.     Identify individuals from the denominator with a prescription for glucagon

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 – Basal Insulin 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 will include other high-risk diabetes medications.

Harmonization¹

Payors: N/A

Providers: N/A