Maneuvers evaluated for measuring performance in chronic disease management: 1 point was awarded for each maneuver performed (0.5 points were awarded if HbA1c was measured only once in the past y).
| CONDITION | MANEUVER* | EVIDENCE GRADE LEVEL |
|---|---|---|
| CAD | Recommended aspirin† | A |
| Recommended β-blockers‡ | A | |
| Recommended statins§ | Ungraded | |
| Diabetes | Recommended ACE inhibitor|| or ARB¶ | A, A |
| HbA1c measured at least twice in past y | D | |
| Feet examined in the previous 2 y | B | |
| Eyes examined in the previous 2 y | B | |
| CHF | Recommended ACE inhibitor or ARB | A, B |
| Recommended β-blockers | A | |
| COPD | Influenza immunization in the previous 15 mo | A |
| Pneumococcal vaccine in the previous 10 y | C | |
| Recommended bronchodilators | A |
ACE—angiotensin-converting enzyme, ARB—angiotensin receptor blocker, CAD—coronary artery disease, CHF—congestive heart failure, COPD—chronic obstructive pulmonary disease, HbA1c—hemoglobin A1c.
↵* For all medications a minimum of 5 y from the date of evaluation were reviewed for any evidence of recommendation of medication.
↵† Aspirin, acetylsalicylic acid, Entrophen, Novasen, enteric-coated acetylsalicylic acid.
↵‡ Sectral, Monitan, Tenormin, Novo-Atenol, Apo-Atenol, Kerlone, Zebeta, Monocor, Cartrol, Coreg, Trandate, Normodyne, Lopresor, Novo-Metoprol, Betaloc, Apo-Metoprolol, Toprol-XL, Corgard, Trasicor, Levatol, Visken, Novo-Pindol, Inderal, Inderal-LA, Apo-Propranolol, Sotacor, Blocadren, Novo-Timol, Apo-Timol.
↵§ Lovastatin, pravastatin sodium, lovastatin and niacin, simvastatin, fluvastatin sodium, atorvastatin calcium, rosuvastatin, cerivastatin.
↵|| Benazepril, captopril, enalapril, fosinopril, lisinopril, trandolapril, quinapril, quinapril and hydrochlorothiazide, moexipril, cilazapril, ramipril, perindopril.
↵¶ Losartan, losartan and hydrochlorothiazide, irbesartan, irbesartan and hydrochlorothiazide, valsartan, valsartan and hydrochlorothiazide, candesartan cilexetil, cilexetil and hydrochlorothiazide, eprosartan, eprosartan and hydrochlorothiazide, telmisartan, telmisartan and hydrochlorothiazide, olmesartan.
Reprinted from Hogg et al.7