Avoidance of Opioid Medications for Patients with Painful Diabetic Neuropathy

Measure Purpose: Ensure patients with diabetic neuropathy are not inappropriately prescribed opioids

The numerator: patient prescribed an opioid medication

is divided by

the denominator: patients with a diagnosis of diabetic neuropathy.

*This is an inverse measure, and a lower score is desirable.

Required exclusions are removed from the denominator:

• Opioid prescription from a different clinician

Allowable exclusions are removed from the denominator:

• Patients counseled on last visit of calendar year and agreement reached to discontinue opioid medications
• Patients receiving opioids in the setting of a controlled/monitored program to manage opioid dependency
• Patient with active diagnosis of cancer
• Patient admitted to hospice care or patient at end-of-life

Key Phrases

Performance will be calculated using prescription data.

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

• Discussed opioids and patient's medication will be discontinued
• Patient is active at a methadone maintenance program
• Patient recently admitted to hospice

Measure Calculation Example

Dr. Bautista saw 100 patients with a diagnosis of diabetic neuropathy between January 1 and December 31. This is the denominator.

Three of these patients were prescribed an opioid from a different clinician and are excluded from the denominator. Of the remaining 97 patients, Dr. Bautista documented opioid prescriptions for 13 patients. This is the numerator. 

Quality of patient care = 13/(100-3). Dr. Bautista has a score of 13.4% for this measure.