Women with Epilepsy
Measure purpose: Ensure patients of childbearing potential are routinely educated on need for folic acid supplementation, drug-to-drug interactions, and potential medication effects.
The numerator: Patients of childbearing potential (12 years and older) diagnosed with epilepsy counseled at least once a year about how epilepsy and its treatment may affect contraception and/or pregnancy.
Counseling must include a discussion of at least two of the following three counseling topics:
- need for folic acid supplementation
- drug to drug interactions with contraception medications
- potential anti-seizure medications effects(s) on fetal/child development and/or pregnancy
is divided by
the denominator: All individuals of childbearing potential (12 years and older) with a diagnosis of epilepsy.
Measure is met if patient has documentation they are pre-menstrual, post-menopausal, surgically sterile, or reproductive organs absent. CMS will treat these conditions as exclusions.
Key Phrases
Examples of key phrases you could use to meet the measure:
- Counseled on the need for folic acid supplementation
- Discussed interactions between contraceptives and anti-seizure medications
- Discussed potential antiseizure medications effects on fetal development and pregnancy
- Prior hysterectomy
- Had gender confirmation surgery
- Post-menopausal
Quality Improvement and Implementation Resources
Measure Calculation Example
Dr. Cho saw 100 patients of childbearing potential that were 12 years and older between January 1 and December 31 with a diagnosis of epilepsy. This is the denominator.
Four patients were postmenopausal and three had prior hysterectomy or tubal ligation. These seven (4+3) patients do not need counseling. This is treated as an exclusion for use in CMS' payment programs.
Of the remaining 93 patients, Dr. Cho documented discussions on two of three required counseling topics for 28 patients. This is the numerator.
Quality of patient care = (28)/(100-7). Dr. Cho has a score of 30.1% for this measure.