DM022 - Diabetes (with no history of CVD or frailty) on a statin (Retired v50 2025/26)

DM022 - Diabetes (with no history of CVD or frailty) on a statin (Retired v50 2025/26)

Warning
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.                  
Info
The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF).                                                                                    
Idea
This indicator was retired in the contract year 2025/26 and replaced by DM034 to include wider lipid lowering therapies similar to those in the cholesterol indicators.                                         

Indicator definition

Indicator ID

Description

The percentage of patients with diabetes, on the register, aged 40 years or over, with no history of CVD and without moderate or severe frailty, who are currently treated with a statin (excluding patients with type 2 diabetes and a CVD risk score of <10% recorded in the preceding 3 years).

What do the business rules mean?

What makes a patient eligible?

Patients are eligible for the DM022 denominator if they:
  1. are on the Diabetes register
  2. are aged 40 years old or over
  3. without a diagnosis of any of:
    1. CHD
    2. STIA
    3. PAD
    4. Familial hypercholesterolaemia
    5. Unresolved CKD
  4. are not living with moderate or severe frailty

How to achieve the indicator

To meet the criteria for DM022, eligible patients must have had:
  1. an issue of a statin in the 6 months before the end of the QOF year

What will remove patients from eligibility?

  1. Patients who are coded for maximal tolerated cholesterol lowering therapy in the contract year
  2. Patients who have persisting statin contraindications ever or expiring statin contraindications in the contract year
  3. Patients for whom diabetes quality indicator care was unsuitable in the contract year
  4. Patients who chose not to receive a statin in the contract year
  5. Patients who chose not to receive diabetes quality indicator care in the contract year
  6. Patients who have been invited twice (at least 7 days apart) for review
  7. Patients who were diagnosed with diabetes in the last 3 months of the contract year
  8. Patients who were newly registered with the practice in the last 3 months of the contract year

Notes
If a patient achieves the indicator at any point during the year, any exclusions that have also been added are ignored.

SNOMED codes used in this indicator

Warning
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.

Moderate frailty diagnosis codes (MODFRAIL_COD)

SNOMED code

SNOMED code description

1129381000000102

Canadian Study of Health and Aging Clinical Frailty Scale level 6 - moderately frail

925831000000107
Moderate frailty

Severe frailty diagnosis codes (SEVFRAIL_COD)

SNOMED code

SNOMED code description

1129401000000102
Canadian Study of Health and Aging Clinical Frailty Scale level 8 - very severely frail
925861000000102
Severe frailty

Cardiovascular disease (CVD) risk assessment codes (CVDASS2_COD)

SNOMED code

SNOMED code description

1085871000000105

QRISK3 cardiovascular disease 10 year risk calculator score

450759008
Framingham coronary heart disease 10 year risk score
718087004
QRISK2 cardiovascular disease 10 year risk score
752451000000100
Cardiovascular disease risk assessment by third party
763244005
QRISK cardiovascular disease 10 year risk calculator score
809311000000105
Joint British Societies cardiovascular disease risk score

Codes indicating the patient is on maximal tolerated cholesterol lowering treatment (CHOLMAX_COD)

SNOMED code

SNOMED code description

407568002

Patient on maximal tolerated lipid lowering therapy

Statin contraindications (persisting) (XSTAT_COD)

SNOMED code

SNOMED code description

16524331000119104

History of rhabdomyolysis due to statin

293432006
3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor adverse reaction
293433001
Adverse reaction caused by simvastatin
293434007
Adverse reaction caused by fluvastatin
293435008
Adverse reaction caused by pravastatin
294970008
Allergy to 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor
294971007
Allergy to simvastatin
294972000
Allergy to fluvastatin
294973005
Allergy to pravastatin
787206005
Rhabdomyolysis due to statin

Statin contraindications (expiring) (TXSTAT_COD)

SNOMED code

SNOMED code description

134391005

Statin not indicated

315363002
Statins contraindicated
413174003
Statin not tolerated

Codes for diabetes quality indicator care unsuitable for patient (DMPCAPU_COD)

SNOMED code

SNOMED code description

717421000000100

Excepted from diabetes quality indicators - patient unsuitable

Codes indicating the patient has chosen not to receive a statin prescription (STATINDEC_COD)

SNOMED code

SNOMED code description

134396000

Statin declined

Codes indicating the patient has chosen not to receive diabetes quality indicator care (DMPCADEC_COD)

SNOMED code

SNOMED code description

716031000000106

Excepted from diabetes quality indicators - informed dissent