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Pharmacotherapy Management of COPD Exacerbation

Advantage MD, EHP, Priority Partners, and USFHP.  Members 40 years of age and older.

The percentage of COPD exacerbations for members 40 years of age and older who had an acute inpatient discharge or ED visit on or between January 1 and November 30 and were dispensed appropriate medications. Two rates are reported:

  • Dispensed a systemic corticosteroid (or there was evidence of an active prescription) on or within 14 days of the event - COPD exacerbation.
  • Dispensed a bronchodilator (or there was evidence of an active prescription) within 30 days of the event.

Best Practice and Measure Tips

The denominator for this measure is based on discharges and not members specifically.

  • Members with active prescriptions for these medications are administratively compliant with the measure.
  • An active prescription is one that’s noted as having available medication left in the “days’ supply” through the episode date or further.
  • The “episode date” for an acute inpatient stay is the admission date.
  • The “episode date” for the emergency department visit is the date of service. 
  • Follow up with members to make sure any new prescriptions are filled post-discharge.

Measure Exclusions

Required Exclusion: Hospice.

Measure Medications

  • Systemic Corticosteroid Medications on or 14 days after the Episode Date.
  • Glucocorticoids:
    • Cortisone-acetate
    • Dexamethasone
    • Hydrocortisone
    • Methylprednisolone
    • Prednisolone
    • Prednisone
  • Bronchodilator Medications on or 30 days after the Episode Date.
  • Anticholinergic agents:
    • Albuterol
    • Ipratropium 
    • Tiotropium
    • Aclidiniumbromide
    • Umeclidinium
  • Beta 2-agonists:
    • Albuterol
    • Arformoterol
    • Formoterol
    • Indacaterol
    • Levalbuterol
    • Metaproterenol
    • Salmeterol
  • Bronchodilator combinations:
    • Albuterol-ipratropium
    • Budesonide-formoterol
    • Dyphylline-guaifenesin
    • Fluticasone-salmeterol
    • Fluticasone-vilanterol
    • Fluticasone furoate-umeclidinium-vilanterol
    • Formoterol-aclidinium
    • Formoterol-glycopyrrolate
    • Formoterol-mometasone
    • Indacaterol-glycopyrrolate
    • Olodaterol hydrochloride
    • Olodaterol-tiotropium
    • Umeclidinium-vilanterol
  • Antiasthmatic combinations:
    • Dyphylline-guaifenesin