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Pharmacotherapy Management of COPD Exacerbation (PCE)

HEDIS Measure

Pharmacotherapy Management of COPD Exacerbation (PCE)

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative (Claims)

Measure Description

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–November 30 of the measurement year and who were dispensed appropriate medications.

Two rates are reported:

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

Numerator Compliance

Systemic Corticosteroid - Dispensed prescription for systemic corticosteroid (Systemic Corticosteroid Medications List) on or 14 days after the episode date.

Bronchodilator - Dispensed prescription for a bronchodilator (Bronchodilator Medications List) on or 30 days after the episode date. Count bronchodilators that are active on the relevant date.

Episode Date - The date of service for any acute inpatient discharge or ED visit during the Intake Period with a principal diagnosis of COPD.

  • For an acute inpatient discharge, the Episode Date is the date of discharge.
  • For direct transfers (to acute or non-acute settings), the Episode Date is the discharge date from the transfer admission.
  • For an ED visit, the Episode Date is the date of service.

Systemic Corticosteroid Medications

Description Prescriptions
Glucocorticoids Cortisone, Dexamethasone, Hydrocortisone, Methylprednisolone, Prednisolone, Prednisone

Bronchodilator Medications

Description Prescriptions
Anticholinergic agents Aclidinium bromide, Ipratropium, Tiotropium, Umeclidinium
Beta 2-agonists Albuterol, Arformoterol, Formoterol, Indacaterol , Levalbuterol, Metaproterenol, Olodaterol , Salmeterol
Bronchodilator combinations Albuterol-ipratropium, Budesonide-formoterol, Fluticasone-salmeterol, Fluticasone-vilanterol, Fluticasone furoate-umeclidinium-vilanterol Formoterol-aclidinium, Formoterol-glycopyrrolate, Formoterol-mometasone, Glycopyrrolate-indacaterol, Olodaterol-tiotropium, Umeclidinium-vilanterol