Quality measures for anticoagulation care.
OBJECTIVE
To systematically identify and assess current quality measures for anticoagulation in atrial fibrillation (AF), venous thromboembolism (VTE) treatment and surgical VTE prophylaxis.


METHODS
Fifteen quality measure websites were searched as were bibliographic databases (January 2000-February 2016). Quality measures were included if developed in the United States and incorporating an aspect of anticoagulation for the aforementioned indications or if applicable but not indication specific (non-disease specific measure). Two reviewers independently extracted data regarding the characteristics of each quality measure.


RESULTS
Thirty-five measures were identified, mostly in VTE treatment (48.6%), followed by non-disease specific measures (25.7%), AF (17.6%) and surgical VTE prophylaxis (8.8%). Process measures predominated (82.9%). A majority of quality measures (65.7%) were focused on parenteral anticoagulants or warfarin and not applicable to novel oral anticoagulants (NOACs). Ten (28.6%) measures are used by the Centers for Medicare and Medicaid Services or as a core measure of The Joint Commission. Limitations include the inability to statistically pool data and possible publication bias given the nature of databases for quality measures.


CONCLUSIONS
Quality measures are recognized in anticoagulation care. Areas for improvement include expanding beyond process measures and capturing adverse events and the advantages offered by NOACs.
a University of Connecticut School of Pharmacy , Storrs , CT , USA.
Diana M
DM
Sobieraj
a University of Connecticut School of Pharmacy , Storrs , CT , USA.
C Michael
CM
White
b Division of Cardiology , Hartford Hospital , Hartford , CT , USA.
Matthew
M
Parker
c Janssen Scientific Affairs, LLC , Raritan , NJ , USA.
Brahim K
BK
Bookhart
a University of Connecticut School of Pharmacy , Storrs , CT , USA.
Craig I
CI
Coleman
Anticoagulants; Atrial fibrillation; Quality measures; Thrombosis; Venous thromboembolism