Performance Measurement Network

Question: Why does a patient on another lipid-lowering medication qualify and fail statin prescribed at discharge?


This question has follow-up question(s): Why does a patient treated with another lipid-lowering agent and with LDL < 100 fail the statin measure?

The patient was on gemfibrozil at the time of hospital arrival, which qualifies them for inclusion in the denominator. Gemfibrozil was ordered at discharge; however, it is not on the medication list of statin medications (Appendix C, Table 8.1 of the specifications manual). Can you please explain why this drug at admission is qualifying the patient for the measure if they won't pass the measure going home on the same drug?

Answer:

Per the AHA/ASA clinical guideline recommendations, statins are the therapy of choice for stroke patients with elevated lipids greater than or equal to 100 mg/dL (or greater than 70 mg/dL if high risk candidates). Gemfibrozil is a lipid-lowering agent in the fibrate category and not a statin medication. The expectation is that stroke patients taking lipid-lowering medications other than statins prior to their inpatient stroke admission will be switched to statin therapy at discharge. If the physician decides that statin therapy is not indicated for the patient,then the physician/APN/PA or pharmacist must document a "Reason for Not Prescribing Statin Therapy at Discharge" in the medical record, in order to exclude the case. Only patients prescribed Statin Medication at Discharge are included in the STK-6 numerator.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK-06, Appendix: Medication tables
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