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. 2011 Feb;14(1):43–54. doi: 10.1089/pop.2010.0019

Table 1.

Disease-Specific Criteria for Inclusion in the Study

Disease Inclusion Criteria Exclusion Criteria Any Acceptable Medications
Asthma Patents were included if they were ≥4 years of age and had 1 medical encounter with asthma (ICD-9 code 493.xx) as the primary diagnosis, OR at least 2 outpatient encounters with asthma as a secondary diagnosis, OR a diagnosis and an asthma medication fill. Patents were excluded if they had any diagnosis of emphysema or COPD. Any appropriate asthma medication included cromolyn, inhaled corticosteroids (ICS), ICS + long-acting beta agonists (LABA) fixed-dose combination, leukotriene modifiers (LTM), and xanthines
Chronic obstructive pulmonary disease (COPD) Patients were included if they were ≥40 years of age and had 1 medical encounter with a primary diagnosis of COPD (ICD-9 code 491.xx, 492.xx, or 496.xx) or 2 with secondary diagnoses of COPD. None Any appropriate COPD medication included anticholinergics (AC), LTM, xanthines, and ICS + LABA, short-acting beta-agonist (SABA) + AC fixed-dose combinations.
Coronary artery disease (CAD) Patients were included if they had a diagnosis of CAD (ICD-9 codes 410.x to 414.x or 429.2x). None Any appropriate CAD medication included angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blocker (ARB), beta-blockers, anticoagulants, antiplatelets, and any fixed-dose combination product of any of these.
Depression Patients were included if they had 1 medical encounter with major depression (ICD-9 codes 296.2, 296.3, 298.0, 300.4, 309.1, or 311) as the primary diagnosis, OR 2 outpatient or 1 inpatient encounter with secondary diagnoses of depression Patients with schizophrenia or bipolar disorder were excluded. Any appropriate depression medication included monoamine oxidase inhibitors, selective norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors, tricyclic antidepressants, and other antidepressants
Diabetes Patients were included if they had 2 medical encounters for diabetes (ICD-9 code 250.xx), or 1 medical encounter for diabetes and a prescription fill for insulin, or an oral antidiabetic medication, or 1 prescription fill for insulin. Patients were excluded if they had only 1 inpatient or outpatient encounter for type I diabetes and lacked a prescription fill for insulin or an oral antidiabetic medication. Any appropriate diabetes medication included alpha-glucosidase inhibitors, biguanides, D-phenylalanine derivative, meglitinides, sulfonylureas, thiazolidinedione or any fixed dose combination of these. Insulin was included in any appropriate medication percentages and excluded in any appropriate oral medication percentage and adherence measures.
Heart failure Patients were included if they had a diagnosis of heart failure (ICD-9 codes 398.91, 428.xx, 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 404.03, 404.13, 404.93) None Any appropriate cardiovascular medication included ACE inhibitors, alpha-beta blockers, ARB, beta-blockers, calcium channel blockers, digitalis, direct vasodilators, diuretics, nitrates, antiarrythmias, anticoagulants, antiplatelets, any appropriate lipid-lowering medication, or any fixed-dose combination product of any of these.
Hyperlipidemia Patients were included if they had a diagnosis of hyperlipidemia (ICD-9 codes 272.0-272.4 or 272.9) or had a prescription fill for at least 1 antihyperlipidemic agent. Patients were excluded if they had evidence of CAD (ICD-9 codes 410.x to 414.x, or 429.2x). Any appropriate lipid-lowering medication included statins, bile acid sequestrants, or other antihyperlipidemic medications (clofibrate, gemfibrozil, nicotinic acid, ezetimibe, and fenofibrate).
Hypertension Patients were included if they were diagnosed with hypertension (ICD-9 codes 401.xx to 405.xx). Patients were excluded if they had evidence of heart failure (ICD-9 codes 398.91, 428.xx, 402.01, 402.11, 402.91, 404.01, 404.11, 404.91, 404.03, 404.13, 404.93), stroke (434.91, 434.11, 430, 431, 432.0–432.9, 434.01), or myocardial infarction (410.x1). Any appropriate hypertensive medication included ACE inhibitors, alpha-adrenergic agonists, alpha-beta blockers, ARB, beta-blockers, calcium channel blockers, central alpha agonists, direct vasodilators, diuretics, peripheral agents, and any fixed-dose combination product of any of these.

Condition-specific inclusion criteria including diagnosis codes and medications were obtained from published literature and current treatment guidelines17,19,20,2226 for each condition of interest.