Adherence to Antipsychotic Medications for Individuals with Schizophrenia
Percentage of individuals at least 18 years of age as of the beginning of the measurement period with schizophrenia or schizoaffective disorder who had at least two prescription drug claims for antipsychotic medications and had a Proportion of Days Covered (PDC) of at least 0.8 for antipsychotic medications during the measurement period (12 consecutive months).
ACP does not support MIPS measure ID# 383 (NQF ID# 1879): “Adherence to Antipsychotic Medications for Individuals with Schizophrenia.” While this measure represents an important clinical concept, the reliability data proposed by the measure developers in the use case scenario is low for patient thresholds of <45 people. This measure may be more meaningful if implemented in plan-level reporting programs where it could promote improvement in care management, rather than targeting individual clinicians who are doing their best to treat a difficult population. Furthermore, developers should consider revising the specifications to include some element of risk adjustment to avoid penalizing clinicians who treat a larger proportion of patients who are diagnosed with severe schizophrenia. We would be more supportive of this measure if the developers cited strong evidence for how best to improve adherence among individuals with schizophrenia.