avoidance of Anticholinergic medications for patients with mild cognitive impairment

Measure purpose: Reduce the number of patients with mild cognitive impairment (MCI) prescribed anticholinergic medications.

This is an inverse measure where a lower score indicates better quality. 

The numerator: patients who were taking anticholinergic medications* in the measurement period

is divided by

The denominator: patients with a diagnosis of MCI.

Exclusions are removed from the denominator:

• Patient at end-of-life or admitted to hospice care
• Patient receiving cancer chemotherapy

*See measure specifications for comprehensive list of anticholinergic medications. Measure performance is calculated on the date of the last encounter in the calendar year. This allows for clinicians and patients to adequately discuss and discontinue anticholinergic medications as clinically appropriate. 

Key Phrases

Examples of key phrases you could use to meet the measure include:

• Patient not taking any anticholinergic medications
• Patient taking olanzapine (or benztropine, clozapine, flavoxate, etc.)
• Patient receiving end-of-life care
• Patient receiving cancer chemotherapy

Measure Calculation Example

This is an inverse measure where a lower score equals better performance.

Dr. Jones sees 100 patients between January 1 and December 31 that were diagnosed with MCI. This is the denominator.

Of the 100 patients, Dr. Jones notes 23 patients are taking an anticholinergic medication. This is the numerator.

Four patients are admitted to hospice or receiving end-of-life care. They are removed from the denominator as exclusions. 

Quality of patient care = 23/(100-4). Dr. Jones has a score of 23.9% for this measure.