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Adherence to Statins for Individuals with Diabetes Mellitus

CBE ID
0545
1.4 Project
Cardiovascular
Endorsed
Endorsement Status
Endorsement Removed
1.1 New or Maintenance
Maintenance
E&M Cycle
Spring 2018
Is Under Review
No
1.3 Measure Description

The measure addresses adherence to statins. The measure is reported as the percentage of eligible individuals with diabetes mellitus who had at least two prescriptions for statins and who have a Proportion of Days Covered (PDC) of at least 0.8 during the measurement period (12 consecutive months).

    • 1.14 Numerator

      Individuals in the denominator with at least two prescriptions for statins with a PDC of at least 0.8 for statins.

    • 1.15 Denominator

      Individuals at least 18 years of age as of the beginning of the measurement period with diabetes mellitus and at least two prescriptions for statins during the measurement period (12 consecutive months).

    • Exclusions

      We excluded the following individuals from the denominator:
      Individuals with polycystic ovaries, gestational diabetes, or steroid-induced diabetes who do not have a face-to-face visit with a diagnosis of diabetes in any setting during the measurement period.
      Exclusion 1
      Individuals with a diagnosis of polycystic ovaries who do not have a visit with a diagnosis of diabetes in any setting during the measurement period*; and,

      Exclusion 2
      Individuals with a diagnosis of gestational diabetes or steroid-induced diabetes who do not have a visit with a diagnosis of diabetes mellitus in any setting during the measurement period.

      *Adapted from NCQA HEDIS 2013 (2013). Note: HEDIS uses a look-back period of one year prior to the measurement period for both the prescription data and diagnosis.

    • Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed Cardiovascular Spring Cycle 2018
      Initial Endorsement
      Last Updated
      Removal Date
    • Steward
      Centers for Medicare & Medicaid Services
      Steward Organization Email
      [email protected]
      Steward Organization Copyright

      Limited proprietary coding is contained in the measure specifications for user convenience. Use of these codes may require permission from the code owner or agreement to a license.

      ICD-10 codes are copyright © World Health Organization (WHO), Fourth Edition, 2010. CPT® 2010 American Medical Association; CPT is a registered trademark of the American Medical Association. All rights reserved.