High Risk Medications Update Notification  

With the April 2017 EQuIPP refresh notice, many EQuIPP users may have noticed an increase in performance scores associated with the High Risk Medication Use in the Elderly (HRM) measure. As a reminder, lower performance scores for the measure represents better performance. In an effort to maintain real-time performance trending on new or expired NDCs within EQuIPP, PQS typically updates NDC lists relevant to its hosted measures on a monthly basis. As the NDC list for the HRM measure is based upon a published list of medications, PQS manages the measure updates in accordance with the measure steward the Pharmacy Quality Alliance (PQA).  

The recent NDC changes to the HRM measure were related to updates adopted by PQA based on changes from the American Geriatric Society's maintenance of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The HRM measure was updated to now exclude three drugs and add fourteen new HRM drugs (see below). The most recent medication list supporting the change above was implemented in a March 2017 update to the PQA measure specifications. The updated list has been applied to the April 2017 release in the EQuIPP dashboard.  

As a result of the measure changes described above, performance rates for HRM measure may have increased, thereby negatively impacting performance (lower score is better). In an effort to quantify the population-based impact of the revision for Medicare health plan sponsors, CMS detailed that the overall HRM measure rate may increase on average by 3.5% for MAPD contracts and 3.3% for PDP contracts which translates to more patients on these meds impacting pharmacy performance.   

Now excluded from the HRM measure:  

         -   Thioridazine

         -   Trimethobenzamide

         -   Choral hydrate  

Recently added to the HRM measure:

          -   Dimenhydrinate

          -   Meclizine

          -   Atropine

          -   Belladonna alkaloids

           -   Clidinium

          -   Dicyclomine

          -   Hyoscyamine

          -   Scopolamine

          -   Amoxapine

          -   Nortriptyline

          -   Desipramine

          -   Paroxetine

          -   Propantheline

          -   Protriptyline  

The complete revised list of High Risk Medications is listed in the FAQ page of EQuIPP.

          - The Team at Pharmacy Quality Solutions