STIA007 - Stroke taking anticoagulant or antiplatelet
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 |
STIA007 | The percentage of patients with a stroke shown to be non-haemorrhagic, or a history of TIA, who have a record in the preceding 12 months that an anti-platelet agent, or an anti-coagulant is being taken. |
What do the business rules mean?
What makes a patient eligible?
Patients are eligible for the STIA007 denominator if they are on the Stroke register and have a non-haemorrhagic stroke.
How to achieve the indicator
To meet the criteria for STIA007, eligible patients must have had a prescription for one of the following during the contract year:
- Salicylates
- Oral anticoagulants
- Clopidogrel
- Dipyridamole
- OTC salicylates
What will remove patients from eligibility?
- Patients for whom stroke quality care was unsuitable in the contract year
- Patients who chose not to receive salicylates, oral anticoagulants, clopidogrel and dipyridamole in the contract year
- Patients with a code indicating a contraindication or decline to all four of the following drug groups:
- salicylate: persisting or expiring contraindication or aspirin declined in the contract year
- anticoagulant: persisting or expiring contraindication or oral anticoagulant declined in the contract year
- clopidogrel: persisting or expiring contraindication or clopidogrel declined in the contract year
- dipyridamole: persisting or expiring contraindication or dipyridamole declined in the contract year
- Patients who chose not to receive stroke quality indicator care in the contract year
- Patients who have been invited twice for review (at least 7 days apart) in the contract year
- Patients who were diagnosed 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
Persisting means the code has to exist at any time on the record; expiring means the code is only valid for the contract year in which it was recorded.
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.
Codes for Salicylate contraindications (persisting) (XSAL_COD)
SNOMED code | SNOMED code description |
10692681000119108 | Aspirin exacerbated respiratory disease |
241949004 | Non-allergic anaphylaxis caused by aspirin |
241960008 | Aspirin-induced angioedema-urticaria |
269722001 | Adverse reaction caused by salicylate |
292044008 | Aspirin adverse reaction |
293585002 | Allergy to salicylate |
293586001 | Allergy to aspirin |
294201000 | Topical salicylic acid allergy |
402394004 | Urticaria caused by salicylate |
407674008 | Aspirin-induced asthma |
767474001 | Allergy to salicylic acid |
Codes for Salicylate contraindications (expiring) (TXSAL_COD)
SNOMED code | SNOMED code description |
134394002 | Aspirin not indicated |
312451002 | Aspirin prophylaxis contra-indicated |
7861000175101 | Antiplatelet therapy contraindicated |
88171000000109 | Aspirin not tolerated |
8991000175100 | Platelet aggregation inhibitor therapy contraindication |
Codes for Oral anticoagulant contraindications (persisting) (XORANTICOAG_COD)
SNOMED code | SNOMED code description |
107561000000103 | [V]Personal history of warfarin allergy (situation) |
218561001 | Adverse reaction to warfarin sodium (finding) |
218562008 | Adverse reaction to nicoumalone (finding) |
218563003 | Adverse reaction to phenindione (finding) |
293331003 | Anticoagulant adverse reaction (disorder) |
293332005 | Direct acting anticoagulant adverse reaction (disorder) |
293341000 | Indirect acting anticoagulant adverse reaction (disorder) |
293342007 | Coumarin anticoagulant adverse reaction (disorder) |
293343002 | Nicoumalone adverse reaction (disorder) |
293344008 | Warfarin adverse reaction (disorder) |
293345009 | Indanedione anticoagulant adverse reaction (disorder) |
293346005 | Phenindione adverse reaction (disorder) |
294869008 | Allergy to anticoagulant (finding) |
294870009 | Direct acting anticoagulant allergy (disorder) |
294878002 | Direct acting anticoagulant allergy (disorder) |
294879005 | Allergy to coumarin anticoagulant (finding) |
294880008 | Allergy to acenocoumarol (finding) |
294881007 | Allergy to warfarin (finding) |
294882000 | Indanedione anticoagulant allergy (disorder) |
| 294883005 | Allergy to phenindione (finding) |
407580005 | History of warfarin allergy (situation) |
407589006 | [V]Personal history of warfarin allergy (situation) |
782560008 | Allergy to indanedione (finding) |
870674008 | Adverse reaction to indanedione (disorder) |
871777003 | Adverse reaction to coumarin (disorder) |
95041000000105 | H/O: warfarin allergy |
985211000000107 | Apixaban adverse reaction (disorder) |
985221000000101 | Apixaban adverse reaction |
985231000000104 | Rivaroxaban adverse reaction (disorder) |
985241000000108 | Rivaroxaban adverse reaction |
985251000000106 | Rivaroxaban allergy (disorder) |
985261000000109 | Rivaroxaban allergy |
985271000000102 | Apixaban allergy (disorder) |
985281000000100 | Apixaban allergy |
99331000000101 | Adverse reaction to warfarin sodium |
99911000000105 | H/O: warfarin allergy |
Codes for Oral anticoagulant contraindications (expiring) (TXORANTICOAG_COD)
SNOMED code | SNOMED code description |
134392003 | Warfarin not indicated (situation) |
315061006 | Warfarin contraindicated (situation) |
413558003 | Anticoagulation contraindicated (situation) |
413560001 | Anticoagulation not indicated (situation) |
413561002 | Anticoagulation not tolerated (situation) |
846181000000104 | Dabigatran contraindicated (situation) |
| 846221000000109 | Dabigatran not indicated (situation) |
846321000000102 | Dabigatran not tolerated (situation) |
88181000000106 | Warfarin not tolerated (situation) |
912841000000100 | Novel oral anticoagulant contraindicated (situation) |
912861000000104 | Novel oral anticoagulant not tolerated (situation) |
912881000000108 | Novel oral anticoagulant not indicated (situation) |
985331000000105 | Apixaban not tolerated (situation) |
985351000000103 | Rivaroxaban not tolerated (situation) |
985631000000101 | Apixaban contraindicated (situation) |
985661000000106 | Rivaroxaban contraindicated (situation) |
Codes for Clopidogrel contraindications (persisting) (XCLO_COD)
SNOMED code | SNOMED code description |
419253001 | Adverse reaction caused by clopidogrel |
89731000000101 | History of clopidogrel allergy |
Codes for Clopidogrel contraindications (expiring) (TXCLO_COD)
SNOMED code | SNOMED code description |
407571005 | Clopidogrel not indicated |
407582002 | Clopidogrel contraindicated |
7861000175101 | Antiplatelet therapy contraindicated |
88191000000108 | Clopidogrel not tolerated |
8991000175100 | Platelet aggregation inhibitor therapy contraindication |
Dipyridamole contraindications (persisting) (XDIPY_COD)
SNOMED code | SNOMED code description |
293539000 | Dipyridamole adverse reaction |
295077001 | Allergy to dipyridamole |
Dipyridamole contraindications (expiring) (TXDIPY_COD)
SNOMED code | SNOMED code description |
196011000000109 | Dipyridamole not tolerated |
196041000000105 | Dipyridamole not indicated |
7611000175100 | Dipyridamole contraindicated |
7861000175101 | Antiplatelet therapy contraindicated |
8991000175100 | Platelet aggregation inhibitor therapy contraindication |
Codes for stroke quality indicator care unsuitable for patient (STIAPCAPU_COD)
SNOMED code | SNOMED code description |
716581000000101 | Excepted from stroke quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to receive salicylate (SALDEC_COD)
SNOMED code | SNOMED code description |
315023008 | Aspirin prophylaxis declined |
985721000000109 | Aspirin declined |
Codes indicating the patient has chosen not to receive oral anticoagulant (ORANTICOAGDEC_COD)
SNOMED code | SNOMED code description |
134398004 | Warfarin declined |
413559006 | Anticoagulation declined |
845121000000109 | Dabigatran declined |
912661000000103 | Novel oral anticoagulant declined |
985291000000103 | Apixaban declined |
985311000000102 | Rivaroxaban declined |
Codes indicating the patient has chosen not to receive clopidogrel (CLODEC_COD)
SNOMED code | SNOMED code description |
407583007 | Clopidogrel declined |
Codes indicating the patient has chosen not to receive dipyridamole (DIPYDEC_COD)
SNOMED code | SNOMED code description |
196051000000108 | Dipyridamole declined |
Codes indicating the patient has chosen not to receive stroke quality indicator care (STIAPCADEC_COD)
SNOMED code | SNOMED code description |
716021000000109 | Excepted from stroke quality indicators - informed dissent |
Invite for stroke care review codes (STIAINVITE_COD)
SNOMED code | SNOMED code description |
1109921000000106 | Quality and Outcomes Framework quality indicator-related care invitation |
1110981000000104 | Quality and Outcomes Framework stroke and transient ischaemic attack quality indicator-related care invitation |
143471000000105 | Quality and Outcomes Framework stroke and transient ischaemic attack quality indicator-related care invitation using preferred method of communication |
415628004 | Stroke/transient ischemic attack monitoring first letter |
415629007 | Stroke/transient ischemic attack monitoring second letter |
415631003 | Stroke/transient ischemic attack monitoring third letter |
417059002 | Stroke/transient ischemic attack monitoring verbal invitation |
417540008 | Stroke/transient ischemic attack monitoring invitation |
717241000000108 | Stroke/transient ischaemic attack monitoring telephone invitation |
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