quality reports : Clinical Quality : Medical Group Performance


Quality Insights: Clinical Quality in Primary Care

Medication Management:
Yearly Follow-up to Monitor Patients on Long-Term ACE Inhibitors or ARBs

Healthcare quality measure: This measure looks at how often doctors follow up with patients who are on long-term ACE (angiotensin converting enzyme) inhibitors or ARBs (angiotensin receptor blockers). These medications are used to treat heart disease, kidney disease, and high blood pressure.

This measure shows the percent of all patients, age 18 and older, who take either of these types of medications for at least six months and have had at least one lab test in the past year to monitor (check) if the medication is having any unwanted side effects.

Reasons for this measure: ACE inhibitors treat high blood pressure, heart failure, diabetes, and kidney disease. ARBs treat high blood pressure (hypertension). Both medications can be very helpful when working correctly. It is important that doctors follow up with patients by ordering a blood test and reviewing the lab test results. Based on lab test results, a doctor may change the medication or its dose.

Patients are more likely to stay healthy and avoid medication problems when they have lab tests ordered by their doctor to check how their medications are working. Medications that are not working correctly can harm a person's health. For instance:

  • More than 700,000 people go to the emergency room because of medication problems each year.
  • One in 6 people who go to the emergency room because of medication problems are then admitted to the hospital.
  • More than $85 billion is spent each year treating problems related to medications.

Click on a column heading to put the results below in order.
Medical Group
Comparison
Rate
Rating
Benchmarks:
   Nat'l Average
   90th Percentile
   MA Rate		 National Average
National 90th Percentile
MA Rate
79.4%
83.9%
83.2%		  
Atrius Health, Inc., Harvard Vanguard Kenmore
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84.0%

 above three benchmarksabove three benchmarksabove three benchmarksabove three benchmarks

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MA Rate (83.2%)

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Explanation of the Star Ratings...

  • above three benchmarksabove three benchmarksabove three benchmarksabove three benchmarks Four stars means the rate is above three benchmarks
  • above two benchmarksabove two benchmarksabove two benchmarksabove two benchmarks Three stars means the rate is above two benchmarks
  • above one benchmarkabove one benchmarkabove one benchmarkabove one benchmark Two stars means the rate is above one benchmark
  • not above benchmarksnot above benchmarksnot above benchmarksnot above benchmarks One star means the rate is not above benchmarks
  • no data available MHQP has too little data to report on this measure. This can happen when the patients or illnesses a medical group cares for are not part of this report.

The three benchmarks used for comparison are:

  • The MHQP Massachusetts Statewide Rate
  • The National 90th Percentile
  • The National Average

Click here to view the MHQP Massachusetts Statewide Rates
and National benchmarks.

For more information on benchmarks, please see Questions & Answers.

Ways your doctor can help...

  • Talk with you about medications. This includes the name of each medication, why you need it, and how to take it (dose, time, and frequency). It also includes talking about any side effects that could occur and what you should do if they happen. Your doctor should answer all your questions about medications.
  • Monitor your progress with the medication. Your doctor may perform lab tests to check that the medication is working the way it is supposed to. Your doctor may ask how the medication makes you feel. Your doctor may change your medication or its dose. He or she will discuss this with you.
  • Review all your medications. Your doctor may ask you to bring a list of all your medications to the appointment. This is a good way to check if any medications might cause problems with others you are taking.

Ways you can help...

  • Know the names of all your medications. Ask your doctor to write down the name and dose of all your medications.
  • Ask your doctor how to use the medication. You might want to ask questions such as: How often should I take this medication? What should I do if I miss a dose? What side effects can I expect? What should I do if they occur?
  • Know how the medication works. Ask your doctor to clearly explain why you are taking this medication and how it can help. Studies show that patients who know about their medications are more likely to take them correctly.
  • Read medication labels and follow all directions. Read the label on the bottle each time you take a medication. This helps make sure you are taking it correctly.
  • Keep a list of all your medications. Make sure this list is up-to-date by making changes each time you stop a medication or start a new one. On this list, include over-the-counter medications (like pain relievers or cold medicine), vitamins, herbal supplements, and any home remedies you may use. Keep this list nearby and give copies to your doctor, family, and/or friends.
  • Talk with the doctor about all your medications. This helps make sure you are taking medications safely and correctly. Bring your medications list to discuss each time you see the doctor.
  • Talk with your doctor about drinking alcohol (including beer, wine, and hard liquor). Sometimes the mix of alcohol and medication can harm your health or make you sick. Ask your doctor if it is safe to drink alcohol while taking certain medications.

Adapted from “6 Tips to Avoid Medication Mistakes,”
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm096403.htm

Ways to learn more...

 

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