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Tobacco Use Screening and Follow-up for People with Serious Mental Illness or Alcohol or Other Drug Dependence

The percentage of patients 18 years and older with a serious mental illness or alcohol or other drug dependence who received a screening for tobacco use and follow-up for those identified as a current tobacco user. Two rates are reported.
Rate 1: The percentage of patients 18 years and older with a diagnosis of serious mental illness who received a screening for tobacco use and follow-up for those identified as a current tobacco user.
Rate 2: The percentage of adults 18 years and older with a diagnosis of alcohol or other drug dependence who received a screening for tobacco use and follow-up for those identified as a current tobacco user.
Note: The proposed health plan measure is adapted from an existing provider-level measure for the general population (Preventive Care & Screening: Tobacco Use: Screening & Cessation Intervention NQF #0028). This measure is currently stewarded by the AMA-PCPI and used in the Physician Quality Reporting System.

Date Reviewed: July 21, 2018

Measure Info

NQF 2600NQF Endorsed
Measure Type: 
Process
Measure Steward: 
National Committee for Quality Assurance

Care Setting: 
Outpatient
Data Source: 
Claims
Electronic Health Records
Paper Medical Records

ACP does not support NQF measure #2600: “Tobacco Use Screening and Follow-up for People with Serious Mental Illness or Alcohol or Other Drug Dependence.” While this measure represents an important clinical concept and patients diagnosed with schizophrenia should be screened for tobacco use, we note several flaws in in the specifications and developers do not cite sufficient evidence to form the basis of the measure. First, the specifications should include some element of risk-adjustment. Treatment success is likely to be confounded by the mental illness. Second, it’s complicated to combine tobacco use with other drug dependence and alcohol dependence because the efficacy of treatment varies by disorder. Third, the specifications do not account for pharmacotherapy options that may be as effective as counseling in managing alcohol- and drug-use disorders. And finally, specifications should include exclusion criteria for patient refusal and patients with limited life expectancy.

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