Psoriasis: Clinical Response to Systemic Medications

Measure Specification

A significant proportion of psoriasis patients who are receiving treatment remain unsatisfied with their therapies due to various reasons including lack of or loss of efficacy, side effects, and inconvenience, among others. Treatment dissatisfaction also contributes to patients discontinuing their medication. This measure evaluates the proportion of psoriasis vulgaris patients receiving systemic medication who meet minimal physician or patient-reported disease activity levels.

It is implied that establishment and maintenance of an established minimum level of disease control as measured by physician and/or patient-reported outcomes will increase patient satisfaction with and adherence to treatment.

1. Treatment goals (assessment after 10 to 16 weeks, and every 8 weeks thereafter): PASI 75 or PGA of ‘clear’ or ‘almost clear’; or DLQI of 0 or 1 (Pathirana, 2009). 2. Minimum efficiency (‘lowest hurdle’): PASI 50; DLQI<5 or improvement by at least 5 points (Pathirana, 2009). 3. Continue therapy if PASI 75 response (or if PASI 50 response and DLQI≤5) (Mrowietz, 2011).

4. Adequate response to treatment is defined as either: a. PASI 50 response (or ≥50% improvement in BSA) and ≥5-point improvement in DLQI; or b. PASI 75 response (Smith, 2009). 5. Treatment ‘success’ defined as PASI 75 response (or PASI 50 response and DLQI≤5) (Baker, 2013).

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this patient-intermediate measure is submitted a minimum of once per patient during the performance period. The most recent quality data code will be used if the measure is submitted more than once.