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Table 2 Summary of final quality assessment criteria designed from candidates accepted in the modified RAM study as appropriate (App) or necessary to do (NecDo)

From: Quality and safety of medication use in primary care: consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement

Condition targeted

Final quality assessment criteria

 

Medication quality category (MQ):

Targeted prescribing

Associated PDRM event

Count

   

App

NecDo

Total

HYPERTENSION

MQ2: Selection of first line antihypertensives

CV events

-

1

13 (25%)

 

MQ3: Blood pressure control

CV events

5

7

 

DIABETES

MQ1: Use of ACEI/ARB if micro-albuminuria

DM complications

-

1

6 (12%)

 

MQ2: Selection of metformin if overweight

DM complications

-

1

 
 

MQ3: HbA1c control

DM complications

2

2

 

AT RISK OF PRIMARY/SECONDARY

VASCULAR EVENTS

MQ1: Use of antiplatelet or anticoagulant

CV events

1

4

17 (33%)

 

Use of statin

CV events

1

3

 
 

Use of ACEI or ARB in CHD

CV events

1

1

 
 

Use of beta blockers in CHD

CV events

-

2

 
 

MQ4: Achievement of target statin dose

CV events

-

4

 

CHRONIC HEART

FAILURE

MQ1: Use of ACEI or ARB

CHF progression

-

1

5(10%)

 

Use of beta blocker

CHF progression

-

1

 
 

MQ2: Selection of beta blocker licensed for CHF

CHF progression

1

-

 
 

MQ4: Achievement of target ACEI/ARB dose

CHF progression

-

1

 
 

Achievement of target BB dose

CHF progression

-

1

 

ATRIAL FIBRILLATION

MQ1: Use of antiplatelet or anticoagulant

Stroke/Embolism

-

3

4(8%)

 

MQ2: Selection of warfarin in high risk of stroke

Stroke/Embolism

-

1

 

ASTHMA

MQ1: Use of inhaled corticosteroid

Asthma exacerbation

1

3

4 (8%)

OSTEOPOROSIS

MQ1: Use of bone protecting agent

Fractures

-

1

3(6%)

 

Use of calcium/vitamin D supplement

Fractures

-

2

 

Total

  

12

40

52 (100%)

Medication Quality categories

 

1. INDICATION

MQ1: Need for treatment to control condition

4

22

26 (52%)

2. SELECTION

MQ2: Selection of first line option within drug class

1

3

4 (8%)

3. INTENSITY

MQ3: Achievement of intermediate outcome target

7

9

16 (31%)

 

MQ4: Achievement of target dose

-

6

6 (12%)

Criteria restricted to the elderly

Aged ≥ 75

  

4

4

8 (15%)

Aged ≥ 80

  

-

2

2 (4%)

  1. MQ1 to 4 refer to medication quality categories as specified in the bottom half of the table.