Overuse of Barbiturate and opioid containing medication for primary headache disorders
Measure Purpose: Promote use of appropriate first line therapy
The numerator: Patients assessed for opioid or barbiturate containing medication overuse headache within the 12 month measurement period, and if barbiturate or opioid medication overuse headache is identified, treatment or referral for treatment was provided
is divided by
The denominator: All patients aged 12 years and older diagnosed with a primary headache disorder and prescribed an opioid or barbiturate containing medication
Exclusions are removed from the denominator for:
- Patient already assessed and treated for opioid use disorder within the last year
- Patient has a documented failure of non-opioid options and does not have an opioid use disorder
- Patient has contraindications to all other medications for primary headache
Key Phrases
Examples of key phrases you could use to meet the measure:
Assessment
- Assessment for opioid overuse headache
- Assessment for barbiturate overuse headache
Referral/Treatment
- Referred for treatment
- Overuse identified, referred for treatment
Measure Calculation Example
Dr. Watson had 50 patients over the age of 12 diagnosed with a primary headache disorder and prescribed an opioid or barbiturate containing medication. This is the denominator. Five patients have documentation of failure of non-opioid options, one patient has already been assessed and treated for opioid use disorder within the last year, and two patients have contraindications to all other medications for primary headache. These patients are removed from the denominator.
Of the remaining 42 patients, 12 were assessed for opioid or barbiturate containing medication overuse headache and ten of these patients were overusing opioids or barbiturates and were referred for treatment. Two patients were not offered treatment or referral to treatment. The numerator is ten.
Quality of care = 10/(50-8). Dr. Watson has a score of 23% for this measure.