CD002 - Cardiovascular disease, age 80+, no frailty BP 150/90 mmHg or less (or equivalent)
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.
The information contained within this article is from version 50 of the Business Rules for Quality and Outcomes Framework (QOF).
Indicator definition
Indicator ID | Description |
CD002 | The percentage of patients with coronary heart disease and/or stroke/TIA, aged 80 years or over, without moderate or severe frailty in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less, (or equivalent home blood pressure reading) |
What do the business rules mean?
What makes a patient eligible?
Patients are eligible for the CD002 denominator if they are on the STIA or CHD registers and are at least 80 years old with no moderate or severe frailty.
How to achieve the indicator
To meet the criteria for CD002, eligible patients must have met one of the following requirements:
- a latest blood pressure measured in clinic (ie: one that is not ambulatory or home-based) that was at most 150/90mmHg
- a latest blood pressure which was from an ambulatory test that was at most 145/85mmHg
- a latest blood pressure measured at home by the patient that was at most 145/85mmHg
What will remove patients from eligibility?
- Patients who have been coded as receiving maximal blood pressure therapy in the contract year
- Patients for whom STIA or CHD quality care was unsuitable in the contract year
- Patients who chose not to have their blood pressure recorded or undertake home blood pressure or ambulatory blood pressure monitoring
in the contract year - Patients who chose not to receive STIA or CHD quality indicator care in the contract year
- Patients who have been invited twice for STIA or CHD (as long as they have the condition) at least 7 days apart for review with no subsequent blood pressure reading
- Patients whose most recent BP reading in the contract year was followed by two invites for STIA or CHD (as long as they have the condition) (ie: a raised result which needs re-checking)
- Patient who were diagnosed with hypertension in the last 9 months of the contract year
- Patients who were newly registered with the practice in the last 9 months of the contract year
If a patient achieves the
indicator at any point during the year, any exclusions that have also been
added are ignored.
What are the common pitfalls/what do I need to watch out for?
Separately coded systolic and diastolic values (especially for a clinic based reading) may not be counted towards the indicator.
- Ensure all clinicians are aware of the coding requirements.
- Ensure all clinicians are aware of the blood pressure target thresholds and their impact on the indicator, especially towards the end of the contract year.
SNOMED codes used in this indicator
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.
Codes for moderate frailty (MODFRAILTY_COD)
| Code | Display |
|---|---|
| 925831000000107 | Moderate frailty |
Codes for severe frailty (SEVFRAILTY_COD)
| Code | Display |
|---|---|
| 925861000000102 | Severe frailty |
Clinic blood pressure readings (CLINBP_COD)
120 codes so truncated:
| Code | Display |
|---|---|
| 163020007 | O/E - blood pressure reading |
| 386536003 | Systemic blood pressure |
| 407556006 | Lying systolic blood pressure |
| 6797001 | Mean blood pressure |
| 251076008 | Non-invasive arterial pressure |
| 23154005 | Diastolic arterial pressure above reference range |
| 1105331000000106 | Blood pressure measurement using oscillometric monitoring device with opportunistic atrial fibrillation detection |
| 386534000 | Arterial blood pressure |
| 170582005 | O/E - check high BP |
| 271871003 | BP reading labile |
| 400974009 | Standing systolic blood pressure |
| 313005002 | O/E - BP reading: no postural drop |
| 72313002 | Systolic arterial pressure |
Codes for home or ambulatory blood pressure readings (HOMEAMBBP_COD)
| Code | Display |
|---|---|
| 413606001 | Average home systolic blood pressure |
| 213031000000105 | Ambulatory systolic blood pressure |
| 314438006 | Minimum systolic blood pressure |
| 314446007 | Average day interval systolic blood pressure |
| 2181381000000109 | Average ambulatory systolic blood pressure |
| 1162737008 | Self reported systolic blood pressure |
| 723236006 | Minimum blood pressure |
| 314462001 | Average 24 hour diastolic blood pressure |
| 116711000000107 | Blood pressure recorded by patient at home |
| 314463006 | 24 hour blood pressure |
| 2181371000000107 | Average ambulatory blood pressure |
| 314442009 | Minimum night interval systolic blood pressure |
| 314449000 | Average 24 hour systolic blood pressure |
| 314465004 | 24 hour diastolic blood pressure |
| 413153004 | Blood pressure recorded by patient at home |
| 314454009 | Minimum day interval diastolic blood pressure |
| 213051000000103 | Ambulatory diastolic blood pressure |
| 198091000000104 | Ambulatory diastolic blood pressure |
| 314447003 | Minimum 24 hour systolic blood pressure |
| 1162735000 | Self reported diastolic blood pressure |
| 164783007 | Ambulatory blood pressure recording |
| 314440001 | Average systolic blood pressure |
| 723232008 | Average blood pressure |
| 314451001 | Minimum diastolic blood pressure |
| 314461008 | Average day interval diastolic blood pressure |
| 141947003 | Ambulatory blood pressure recording |
| 314460009 | Average night interval diastolic blood pressure |
| 121281000000107 | Blood pressure recorded by patient at home |
| 314445006 | Average night interval systolic blood pressure |
| 147845001 | 24 hr blood pressure monitoring |
| 314455005 | Minimum night interval diastolic blood pressure |
| 413605002 | Average home diastolic blood pressure |
| 1285115008 | Average home blood pressure |
| 337061000000109 | Self measured blood pressure reading |
| 314464000 | 24 hour systolic blood pressure |
| 198081000000101 | Ambulatory systolic blood pressure |
| 2181391000000106 | Average ambulatory diastolic blood pressure |
| 335661000000109 | Self measured blood pressure reading |
| 213061000000100 | Ambulatory diastolic blood pressure |
| 314456006 | Minimum 24 hour diastolic blood pressure |
| 337501000000104 | Self measured blood pressure reading |
| 213041000000101 | Ambulatory systolic blood pressure |
| 314441002 | Minimum day interval systolic blood pressure |
| 170599006 | 24 hr blood pressure monitoring |
| 314453003 | Average diastolic blood pressure |
Codes for maximal blood pressure (BP) therapy (HTMAX_COD)
| Code | Display |
|---|---|
| 1303422008 | On maximum tolerated dose of antihypertensive therapy |
| 407567007 | Patient on maximal tolerated antihypertensive therapy |
Codes for STIA quality indicator care unsuitable for patient (STIAPCAPU_COD)
| Code | Display |
|---|---|
| 716581000000101 | Excepted from stroke quality indicators - patient unsuitable |
Codes for CHD quality indicator care unsuitable for patient (CHDPCAPU_COD)
| Code | Display |
|---|---|
| 717111000000104 | Excepted from CHD quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to have blood pressure procedure (BPDEC_COD)
| Code | Display |
|---|---|
| 413123006 | Blood pressure procedure declined |
Codes indicating patient chosen not to undertake home blood pressure measurement (HBPM) (HOMEBPDEC_COD)
| Code | Display |
|---|---|
| 1085031000000100 | Home blood pressure monitoring declined |
Codes indicating patient chosen not to undertake ambulatory blood pressure monitoring (ABPM) (ABPMDEC_COD)
| Code | Display |
|---|---|
| 861231000000105 | Ambulatory blood pressure recording declined |
Codes indicating the patient has chosen not to receive STIA quality indicator care (STIAPCADEC_COD)
| Code | Display |
|---|---|
| 716021000000109 | Excepted from stroke quality indicators - informed dissent |
Codes indicating the patient has chosen not to receive CHD quality indicator care (CHDPCADEC_COD)
| Code | Display |
|---|---|
| 716091000000107 | Excepted from CHD quality indicators - informed dissent |
Invite for STIA review codes (STIAINVITE_COD)
| Code | Display |
|---|---|
| 143471000000105 | QOF (Quality and Outcomes Framework) stroke and transient ischaemic attack quality indicator-related care invitation using preferred method of communication |
| 415631003 | Stroke/transient ischaemic attack monitoring third letter |
| 1110981000000104 | QOF (Quality and Outcomes Framework) stroke and transient ischaemic attack quality indicator-related care invitation |
| 717241000000108 | Stroke/transient ischaemic attack monitoring telephone invitation |
| 415629007 | Stroke/transient ischaemic attack monitoring second letter |
| 417540008 | Stroke/transient ischaemic attack monitoring invitation |
| 415628004 | Stroke/transient ischaemic attack monitoring first letter |
| 417059002 | Stroke/transient ischaemic attack monitoring verbal invitation |
| 1109921000000106 | QOF (Quality and Outcomes Framework) quality indicator-related care invitation |
Invite for CHD review codes (CHDINVITE_COD)
| Code | Display |
|---|---|
| 248461000000107 | Coronary heart disease monitoring telephone invitation |
| 143451000000101 | QOF (Quality and Outcomes Framework) secondary prevention of coronary heart disease quality indicator-related care invitation using preferred method of communication |
| 1110881000000106 | QOF (Quality and Outcomes Framework) secondary prevention of coronary heart disease quality indicator-related care invitation |
| 401251008 | Coronary heart disease monitoring 2nd letter |
| 401253006 | Coronary heart disease monitoring verbal invitation |
| 1083121000000102 | Coronary heart disease monitoring invitation |
| 401250009 | Coronary heart disease monitoring first letter |
| 1109921000000106 | QOF (Quality and Outcomes Framework) quality indicator-related care invitation |
| 401252001 | Coronary heart disease monitoring 3rd letter |
| 1083131000000100 | Coronary heart disease monitoring invitation email |
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