DM022 - Diabetes (with no history of CVD or frailty) on a statin
The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF).
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:
- are on the Diabetes register
- are aged 40 years old or over
- without a diagnosis of any of:
- CHD
- STIA
- PAD
- Familial hypercholesterolaemia
- Unresolved CKD
- are not living with moderate or severe frailty
How to achieve the indicator
To meet the criteria for DM022, eligible patients must have had:
- an issue of a statin in the 6 months before the end of the QOF year
What will remove patients from eligibility?
- Patients who are coded for maximal tolerated cholesterol lowering therapy in the contract year
- Patients who have persisting statin contraindications ever or expiring statin contraindications in the contract year
- Patients for whom diabetes quality indicator care was unsuitable in the contract year
- Patients who chose not to receive a statin in the contract year
- Patients who chose not to receive diabetes quality indicator care in the contract year
- Patients who have been invited twice (at least 7 days apart) for review
- Patients who were diagnosed with diabetes in the last 3 months of the contract year
- Patients who were newly registered with the practice in the last 3 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.
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.
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 |
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