Table 1.

Final Consensus-Based Quality Measures for Alcohol Misuse

Measure	Measure Statement	Treatment Phase	Validity Mean (SD)
Adequate Identification of Unhealthy Alcohol Use	Proportion of all patients screened for unhealthy alcohol use	Screening and Assessment	7.0 (1.7)
Assess for AUD	IF patient has a new AUDIT-C score ≥ 5, THEN patient should be assessed for an alcohol use disorder (AUD) within 30 days.	Screening and Assessment	6.4 (1.0)
Assess for Major Depressive Disorder in Specialty Care	IF patient has a new AUDIT-C >= 8 or new diagnosis of AUD, THEN patient should be assessed for major depressive disorder within 30 days before or after index visit (specialty care).	Screening and Assessment	7.1 (2.4)
Screen for Major Depressive Disorder in Primary Care	IF patient has a new AUDIT-C >= 8 or new diagnosis of AUD, THEN patient should be screened for major depressive disorder within 30 days before or after index visit (primary care).	Screening and Assessment	6.4 (2.2)
Screen for Suicidal Ideation	IF patient has AUDIT-C >=8 or an AUD diagnosis, THEN patient should be screened for suicide within 30 days before or after index visit.	Screening and Assessment	6.1 (1.9)
Liver Function Test	IF patient has AUDIT-C >=8 or an AUD diagnosis, THEN patient should be screened for liver disease within 30 days before or after index visit.	Screening and Assessment	6.3 (2.3)
Screening for Other Substance Use in Any Care Setting	IF patient has a new AUDIT-C score ≥ 5, THEN patient should be screened for other substance use (including tobacco) within 30 days of the index visit.	Screening and Assessment	6.9 (1.9)
Assessment of Drug Use in Specialty Care	IF patient has a new AUDIT-C score >=8 and is seeing a mental health specialist, THEN patient should be assessed for other substance use (including type, frequency, and recency) within 30 days of the index visit.	Screening and Assessment	7.6 (1.4)
Brief Intervention	IF patient has a new AUDIT-C score ≥ 5, THEN patient should receive a brief intervention within 30 days following the index visit.	Treatment	8.2 (1.1)
Discuss Treatment Options	IF patient has a new AUDIT-C score ≥ 8 or an AUD, THEN patient should receive counseling regarding treatment options within 30 days following the index visit.	Treatment	7.1 (1.1)
Psychotherapy Offer	IF patient has AUDIT-C >= 8 or an AUD, THEN patient should be offered psychotherapy.	Treatment	6.2 (1.9)
Psychotherapy Dose	IF patient has AUDIT-C >= 8 or an AUD and one or more psychotherapy visits, THEN patient should receive at least 4 visits within the first 12 weeks.	Treatment	7.2 (2.0)
Psychotherapy Quality	IF patient has AUDIT-C >= 8 or an AUD and one or more psychotherapy visits, THEN the visit should include elements of an evidence-based psychotherapy.	Treatment	6.3 (2.4)
Pharmacotherapy for Alcohol Dependence	IF patient has a newly identified diagnosis of alcohol dependence, THEN patient should receive pharmacotherapy for alcohol dependence within 90 days following identification.	Treatment	7.1 (1.8)
Referral to Recovery Support in the Community	IF patient has a new diagnosis of alcohol dependence, THEN patient should be referred to recovery support in the community (e.g. Alcoholics Anonymous) within six months following identification.	Treatment	6.3 (1.9)
Offer of Housing Services	IF patient has a new AUDIT-C score ≥ 8 or an AUD and a documented housing need, THEN patient should be offered housing services within 30 days following identification of the need.	Treatment	6.1 (1.5)
Integrated Co-Occurring Disorder Treatment	IF patient has a current mental health diagnosis and a new AUDIT-C >= 8 or an AUD, THEN there should be evidence that both conditions are addressed as evidenced by treatment goals for both conditions, an integrated treatment plan, OR continuous engagement for both conditions.	Treatment	6.9 (0.9)
Treatment Initiation for Alcohol Dependence	IF patient has a newly identified diagnosis of an AUD, THEN patient should have either an inpatient AUD admission or both an initial AUD-related outpatient visit and an additional AUD-related visit within 30 days of the index visit.	Treatment	6.2 (1.2)
Treatment Engagement for Alcohol Dependence	IF patient has a newly identified AUD diagnosis and has initiated treatment, THEN patient should receive two additional alcohol-related visits within 30 days following treatment initiation.	Treatment	6.9 (1.4)
Reassess Alcohol Use	IF patient has a new AUDIT-C score ≥ 5, THEN patient should have their quantity and frequency of drinking reassessed within 30 days using a structured metric.	Follow-up	6.8 (1.9)
Repeat Brief Intervention	IF patient has a new AUDIT-C >= 5, THEN patient should receive TWO brief interventions within two months of the index visit.	Follow-up	7.6 (1.7)
Pharmacotherapy Evaluation and Management	IF patient started on new medication for alcohol dependence, THEN patient should have at least one alcohol-related follow-up encounter within 30 days of the index visit.	Follow-up	7.1 (1.1)
Any Alcohol-Related Follow-Up	IF patient has a new AUDIT-C score ≥ 5, THEN alcohol should be addressed at next routine visit.	Follow-up	6.9 (0.9)
Detox Follow-up	IF patient receives medication assisted detox, THEN patient should receive alcohol-related outpatient follow-up within 7 days.	Follow-up	7.3 (1.1)
Follow-up Consistent with Chronic Care Management	IF patient receives alcohol treatment, THEN patient should be re-evaluated quarterly and treatment adjusted if necessary.	Follow-up	7.7 (0.9)

Note: Panelists rated statements that referred to “abuse/dependence” and this language has been updated to indicate “alcohol use disorder.” Index visit refers to the visit in which alcohol misuse was detected.