LTCPR-falls-3-or-more-CNS-active-medications - Health Quality Ontario (HQO)

INDICATOR NAME

Name

Three or More CNS-Active Medications: Percentage of residents aged 66 and older who on a given day had prescriptions for three or more specified* CNS-active medications

Alternate Name

Three or More CNS-Active Medications: Percentage of residents aged 66 and older who on a given day had prescriptions for three or more specified* CNS-active medications

INDICATOR DESCRIPTION

Description

This indicator estimates the percentage of residents who had three or more specified* medications dispensed that have central nervous system activity. This is estimated on a given day (the index date) during the reporting period.

HQO Reporting tool/product

Personalized/Custom Reports (includes Practice Reports)

Dimension

Patient-centred

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Percentage

Calculation Methods

Number of residents who on the index date had prescriptions for three or more specified* CNS-active medications divided by the total number of residents who were older than 66 years, not new to the Long-Term Care home, and not in palliative care. This is multiplied by 100.

Numerator (short description i.e. not inclusions/exclusions)

The total number of residents who have three or more specified CNS-active medications dispensed with an Long-Term Care flag on the index date which is defined as the resident’s last service date in the quarter.

Denominator (short description i.e. not inclusions/exclusions)

The total number of residents in the cohort for the reporting period who are 66 years and older, were not new to the Long-Term Care home, and were not in palliative care.

Adjustment (risk, age/sex standardization)- generalized

None

Data Source

Discharge Abstract Database (DAD), Ontario Drug Benefit (ODB), Ontario Health Insurance Plan (OHIP) Claims History Database, Ontario Mental Health Reporting System (OMHRS), Physician Database (IPDB), Registered Persons Database (RPDB)

Data provided to HQO by

Institute for Clinical Evaluative Sciences (ICES)

OTHER RELEVANT INFORMATION

Caveats and Limitations

The indicator also captures medications dispensed that are prescribed on an as-needed basis (PRN). This indicator is strictly for quality improvement efforts, and is not reportable or for accountability. Caveats: These indicators are not intended to assess the appropriateness of the use of these medications. They are designed to identify those residents at increased risk of falls related to the medications, and to aid with quality improvement. For this reason, residents who may have clinical indications for these medications are included in the indicator because these residents would be at an increased risk of falls. Where appropriate, residents may be considered for a trial of weaning, titrating drug dose, or a trial of substituting with a medication that has a lower risk of falls. These indicators are not intended to override clinical judgement, but solely to capture those who may be at an increased risk of falls.