For Professionals & Researchers

Cardiovascular Disease (CVD) Risk Factor Instruments

• CVD Risk Factor Written Patient Survey (English version)
  Includes questions to measure patient activation, the quality of communication between providers and patients, perception of (CVD) risk, the costs of medications and the behaviors patients adopt to cope with high costs, recall of specific dietary and physical activity recommendations along with current lifestyle behaviors, and participatory decision-making style. Contains a total of 211 questions including skip patterns.
  
  
• Spanish Version
  Please note, footnote references are for questions in English that our study researchers had translated into Spanish.
  
  
  
• CVD Risk Factor Chart Review
  Used to collect information from one or more medical records at a patient's primary care provider office. Data captured includes patient medical history, current medications and any other specific diabetes related health information. Medical records abstracted are for a specific review period of 18 months. For detailed information regarding the use of this instrument, please refer to the TRIAD medical chart review instructions.
  

CVD Risk Factor Inclusion Criteria Summary

• Enrolled in a managed care health plan with at least 12 months of continuous enrollment with no more than one gap of up to 45 days;
• English or Spanish-speaking; and
• Age 18 or older.

Each of the 3 following disease definitions:

1. Diagnostic code or chart diagnosis for diabetes that mirrors HEDIS criteria (see attached). We would like to restrict the sample to persons who have had a diagnosis of diabetes for at least 12 months (i.e. not "newly" diagnosed patients). To do this, we will need to search (when possible) 24 months retrospectively for diabetes related claims.  Patients not meeting one or more diabetes diagnoses criteria during the period 12 to 24 months before the audit will not be included.
2. Diagnostic code or chart diagnosis for hypertension (≥1 code for 401.x) OR (≥ 2 outpatient SBP ≥ 160 mmHg with or without a diagnostic code or chart diagnosis)
3. Diagnostic code or chart diagnosis for dyslipidemia (≥1 code for 272.x) OR (a statin prescription AND last LDL ≥ 130 mg/dl) OR (last LDL ≥ 160 mg/dl)

At least one of each of the following test values available:

1. One or more available A1c test results within the past 12 months
2. One or more available LDL-C test results within the past 12 months
3. One or more available SBP measurements within the past 12 months

Our study will evaluate differences between "Cases" and "Controls."  Cases must meet one of the poor control criteria for 2 or more of the 3 risk factors.  Controls must meet the good control criteria for ALL 3 risk factors.

It is important to note that some potentially eligible participants that will not meet the specific requirements for a case or control (for example, only one risk factor meets the criteria for poor control). 

HEDIS Diabetes Enrollment Criteria

Each participant must be:

• Enrolled for at least 320 days throughout the calendar year, with no more than one gap in enrollment of up to a maximum of 45 days;
• Enrolled in a single MCO for the period of enrollment; and
• Enrolled as of Dec. 31st of the year being studied.

Clinical Criteria
Adults aged 18 years and older who met or exceeded at least one of the following utilization thresholds of medical care services in the measurement year or the year prior to the measurement year:

• One dispensed insulin or oral hypoglycemic/antihyperglycemic event;
• One ER visit with a diabetes diagnosis;
• One inpatient visit with a diabetes diagnosis; or
• Two ambulatory care visits with a diabetes diagnosis.

We should attempt to capture all insulin and oral hypoglycemic/antihyperglycemic events during the past 24 months to ascertain eligibility.  However, patients cannot be deemed eligible based on a dispensing event for Metformin alone (i.e. they must also meet a utilization criterion or have a dispensing event for another medication during the interval).

Table A2. Codes to Identify Diabetes Encounters

Return to top of page