Percentage of patients treated for bipolar disorder who are assessed for diabetes within 16 weeks after initiating treatment with an atypical antipsychotic agent.
Measure Specs
General Information
Numerator
Assessment for diabetes must include documentation of one of the following:
• Reference in chart that test was ordered and results or information about results was obtained
OR
• Lab results filed in chart or available in patient’s electronic medical record
Reference: Tests used to screen/assess for diabetes:
Preferred Fasting plasma glucose; Non-fasting plasma glucose; Glucose tolerance Also Accepted: Glycosylated hemoglobin (Hb A1c; glycated hemoglobin) Random glucose AND
Timeframe: Test results/information from test conducted within 16 weeks after the initiation of a second generation atypical antipsychotic agent
OR
Measurement EXCLUSION FROM COMPLIANCE Issues
Numerator criteria not applicable and exclusion from compliance as stated below:
1.Dcumentation by physician that test was not clinically indicated for this patient
OR
2Documentation that test was requested but patient failed to comply with request to obtain test
Denominator
Patients 18 years of age or older with an initial or new episode of bipolar disorder
AND
Documentation of a diagnosis of bipolar disorder; to include at least one of the following:
• Codes 296.0x; 296.1x; 296.4x; 296.5x; 296.6x; 296.7; 296.80; 296.81; 296.82; 296.89; 301.13 documented in body of chart, such as a pre-printed form completed by a clinician and/or codes documented in chart notes/forms
OR
• Diagnosis or Impression or “working diagnosis” documented in chart indicating bipolar disorder
OR
• Use of a screening/assessment tool for bipolar disorder with a score or conclusion that patient has bipolar disorder and documentation that this information is used to establish or substantiate the diagnosis
AND
Documentation of treatment with an atypical antipsychotic agent. (See reference list below)
Note: It is not the intent to indicate preferred pharmacotherapy. The reference list is inclusive of those atypical antipsychotic medications that are reasonably construed to be appropriate in accordance with current guidelines. (Reference list of medications also included in data collection form)
Atypical Antipsychotic Agents
• aripiprazole
• quetiapine
• clozapine
• risperidone
• olanzapine
• ziprasidone
• olanzapine-fluoxetine (combination)
None. New diagnosis” or a “new episode,” is defined as cases where the patient has not been involved in active treatment for 6 months. Active treatment includes being hospitalized or under the out-patient care of a physician.
Exclusions
None.
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