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Disease-Modifying Anti-Rheumatic Drug (DMARD) Therapy for Rheumatoid Arthritis

The percentage of patients 18 years and older by the end of the measurement period, diagnosed with rheumatoid arthritis and who had at least one ambulatory prescription for a disease-modifying anti-rheumatic drug.

Date Reviewed: April 27, 2015

Measure Info

NQF 0054CMS 108NQF Endorsed
Measure Type: 
Process
Measure Steward: 
National Committee for Quality Assurance
Clinical Topic Area: 
Rheumatoid Arthritis

Care Setting: 
Outpatient
Data Source: 
Claims
Electronic Health Records

ACP supports NQF 0054 for physicians managing Rheumatoid Arthritis (RA), with modifications: “Disease-Modifying Anti-Rheumatic Drug (DMARD) Therapy for Rheumatoid Arthritis.” The current evidence supports the benefit of DMARD therapy in reducing the symptoms of RA and decelerating the progression of joint damage. Furthermore, a wide range of DMARD prescribing across health plans in the 2013 measurement year suggests a performance gap. However, given the availability of highly effective therapies and a more aggressive therapeutic approach than in previous decades, remission or minimal disease activity is now achievable for a significant numbers of patients (10-30%). Therefore, DMARD therapy may be appropriately withheld for a period of time (a “drug holiday”) or discontinued for such patients. Hence, minimal disease activity or clinical remission should be included in the denominator exclusions. This is a physician level measure and should only be applicable to physicians who are managing and providing medical therapy for RA. Most often this will apply to rheumatologists, but primary care physicians may also manage RA.

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