PQA Diabetes Cluster Group

1. PQA Diabetes Cluster Group Pharmacy Quality Alliance Quality Measures for Diabetes

2. 2 Gap in Therapy: Diabetes Treatments Description The proportion of patients treated with medications who experience significant gaps in refills Calculated among patients known to be taking medications for diabetes during the study period Rationale Optimize health outcomes through greater adherence to chronic treatments. Gaps are an actionable opportunity that can potentially be recognized by a pharmacist. Denominator Description Number of adults with at least one claim for the treatment of diabetes who were continuously eligible for follow up during the six-month observation period. Numerator Description Number of patients in the denominator who experience a significant gap at least once during the study period Exclusions Patients who reside in long-term care facilities

3. 3 Gap in Therapy: Diabetes Treatments Definitions Gap � a period of time, measured in days, beginning on the last day covered by an Rx claim and ending on the date of the next Rx claim Significant Gap � 30 days in a six-month period Diabetes Treatments - sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha glucosidase inhibitors, all insulins, dipeptidyl-peptidase (DPP-IV) inhibitors and incretin mimetic/amylinomimetic agents Data Source Pharmacy claims data

4. 4 Proportion of Days Covered (PDC): Diabetes Treatments Description Quantify the median proportion of days covered (PDC) for the treatment of diabetes Quantify the percentage of patients who achieved a threshold level of PDC Rationale Optimize health outcomes through greater adherence to chronic treatments. This measure seeks to combine both the duration and intensity of utilization into a single metric. Denominator Description Number of adults with at least one claim for the treatment of diabetes who were continuously eligible for follow up during the six-month observation period. Numerator Description Number of patients in the denominator who meet the PDC threshold during the remainder of the follow up period Exclusions Patients who reside in long-term care facilities

5. 5 Proportion of Days Covered (PDC): Diabetes Treatments Definitions PDC � The proportion of days in the follow-up period �covered� by prescription claims for the medication(s) used to treat diabetes. The follow-up period includes the days between the initial claim and the end of the measurement period. Each day in the follow-up period is determined to be �covered� (or not) based on the quantity dispensed and days supply fields for prescription claims for medications used to treat diabetes. PDC Threshold � The level of PDC above which the treatment regimen has a reasonable likelihood of achieving most of the potential benefit. A preliminary threshold of 60% is recommended; in light of the potential uncertainty in data collection and quality Diabetes Treatments - sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha glucosidase inhibitors, all insulins, dipeptidyl-peptidase (DPP-IV) inhibitors and incretin mimetic/amylinomimetic agents Data Source Pharmacy claims data