Table 1.
Quality Measures to Assess Pain Care
| Measure Topic | Quality Measure | Observed Care |
|---|---|---|
| Acute pain related to procedures | ||
| Opioids and dental procedures | Dental procedures for opioid-naïve patients who initially received short-acting opioids and no more than a 1-day supply or no opioids | FY 2019 |
| Opioids and ambulatory procedures | Ambulatory procedures for opioid-naïve patients who initially received short-acting opioids and no more than a 5-day supply or no opioids | FY 2019 |
| Acute low back pain | ||
| NSAIDs/NPT without opioids | Opioid-naïve patients with acute low back pain who received NSAIDs or any NPT within 3 months and no opioids | FY 2019 |
| Stepped care | Opioid-naïve patients with acute low back pain who received nonopioids or any NPT within 3 months and no opioids or opioids only after nonopioids or NPT | FY 2019 |
| No initiation of benzodiazepines | Opioid-naïve patients with acute low back pain not currently taking benzodiazepines who did not initiate benzodiazepines (≥7 days) within 3 months | FY 2019 |
| Chronic pain | ||
| NPT | Patients with chronic pain who received any NPT within 12 months | FYs 2018 and 2019 |
| Nonopioid medication/NPT | Patients with chronic pain who received any nonopioid medication or NPT within 12 months | FYs 2018 and 2019 |
| Opioid prescribing | ||
| Opioids without concurrent benzodiazepines | Patients who received opioids who did not receive concomitant benzodiazepines (≥7 consecutive days) during the 12-month observation period | FY 2019 |
| Lower-risk average daily dosage | Patients who received opioids and whose average daily dosage was <90 MME during the 12-month observation period | FY 2019 |
| No advancement to LOT | Opioid-naïve patients who received opioids who did not advance to LOT during the 12-month observation period | FYs 2018 and 2019 |
| Naloxone in LOT at higher-risk daily dosage | Patients on LOT dispensed a daily dosage of ≥50 MME and dispensed naloxone within 3 months | FY 2019 |
| Follow-up visit in LOT | Patients on LOT with a follow-up evaluation and management visit at least every 90 days | FYs 2018 and 2019 |
| Urine drug testing in LOT | Patients on LOT who received drug testing at least once during the 12-month observation period | FY 2019 |
| Opioid use disorder | ||
| Medication for OUD∗ | Patients with OUD who received medication treatment for OUD during the 12-month observation period | FY 2019 |
NOTES: Opioid-naïve = no opioids in the previous 90 days. FY = fiscal year. NSAID = nonsteroidal anti-inflammatory drug. MME = morphine milligram equivalent. LOT = long-term opioid therapy.
∗
NQF-endorsed measure.