Performance Measurement Network

Question: Are the following examples acceptable Reasons for Not Prescribing Anticoagulation and Antithrombotic Therapy at Discahrge?

Coumdadin was ordered then discontinued. The physician documents that Coumadin was discontinued because the patient has a history of frequent falls. Is this note an accepatable "Reason for Not Prescribing Anticoagulation Therapy at Discharge"?

The same patient also has an allergy to aspirin. Would documentation of the ASA allergy plus the above documentation constitute a "Reason for Not Prescribing Antithrombotic Therapy at Discharge"?

Answer:

Documentation that coumadin was discharged due to a patient history of falls is an acceptable reason. Select 'Yes' for "Reason for Not Prescribing Anticoagulation Therapy at Discharge".

However, an allergy or adverse reaction (e.g., rash, hives, nausea) to one antithrombotic is not a reason for not prescribing another antithrombotic medication. The antithrombotic category is broad and includes agents other than ASA / ASA-containing medications, e.g. Plavix, dipyridamole. Select 'No' for "Reason for Not Prescribing Antithrombotic Therapy at Discharge", unless dcoumenation is clear that all antithrombotic medications were not indicated for the patient.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical, Related Manual - Data Quality Manual
Related documents: STK, STK-02, Antithrombotic Therapy Prescribed at Discharge,
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