Targeted Medication Fills with Medication Therapy Episodes

Definition

A continuous period of time during which the patient is in supply, or in a gap of supply fewer than 30 days, for any of the following targeted medication types: antidepressants; antineoplastics; beta blockers; antidiabetics; ACEI/ARBs; statins; high-risk medications (anticoagulants, oral antiplatelets, cardiac glycosides, opiate agonists, oral hypoglycemics, or insulin); or other chronic medications. Medications with the same active ingredients (even if they have different strengths) are considered equivalent for the purpose of constructing these episodes.

Purpose

Used in the URSA-PHARM module to construct episodes of fills for targeted medication types.

Related objects

• Outpatient Medication Fills Aggregator for URSA-PHARM Concepts
• Data Mart for Targeted Medication Therapy Episodes
• Patient Timelines for URSA-PHARM Concepts

Detailed narrative of logic

1. At a high level, this logic begins by defining filling encounters in Outpatient Medication Fills Aggregator for URSA-PHARM Concepts as one record per outpatient medication fill based on a pharmacy claim or EMR pharmacy fill record; MDM record matching logic here generates a Lifetime Medication Treatment Episode ID for each fill that allows linking fills with the same patient-ingredient over the lifetime of the patient.
2. Next, restrict analysis in Outpatient Medication Fills Aggregator for URSA-PHARM Concepts, to “qualifying” documents representing outpatient medication fills for targeted medications, defined by value sets for each targeted medication class as determined by either 6-Digit AHFS Therapeutic Class Code, Redbook Generic Cross-Reference Code, or both.
3. Separately from classifying medications into High Risk or Priority Adherence categories, Outpatient Medication Fills Aggregator for URSA-PHARM Concepts classifies as Chronic any medication meeting at least one of the following: (1) 3 or more fills over the history of the patient for this or other medications in the same AHFS Therapeutic Class ; (2) 90 or more days supply over the history of the patient for this or other medications in the same AHFS Therapeutic Class.
4. Next, as implemented in Targeted Medication Fills with Medication Therapy Episodes, all outpatient fills for Targeted Medications, obtained from Outpatient Medication Fills Aggregator for URSA-PHARM Concepts without an earlier outpatient fill for a targeted medication in the same Medication Family Key (as determined by Ingredients Hash) in the prior 30 days are considered to represent the start of a new medication therapy episode. All fills, as long as they fall within 30 days of the prior outpatient fill for a targeted medication in the same Medication Family Key, extend the episode. Medication Therapy episodes are considered to end after 3 prior fill supply days (typically 90 days) since the last dialysis filled date in the episode.