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Performance Measure: Substance Abuse Screening

National Quality Forum #: None

Description: Percentage of new patients1 with a diagnosis of HIV who have been screened2 for substance use (alcohol & drugs) in the measurement year

Numerator: Number of new patients with a diagnosis of HIV who were screened for substance use within the measurement year

Denominator: Number of patients with a diagnosis of HIV who meet both criteria:

  • Were new during the measurement year
  • Had a medical visit with a medical provider with prescribing privileges3 at least once in the measurement year

Patient Exclusions: None

Data Elements:

  1. Does the patient have a diagnosis of HIV? (Y/N)
    1. If yes, was the patient new to the program during the reporting period? (Y/N)
      1. If yes, was the patient screened for substance use during the measurement year? (Y/N)

National goals, target, or benchmarks for comparison

The HIV Quality Measures (HIVQM) Module is a tool within the Ryan White HIV/AIDS Services Report portal. It allows recipients to enter aggregate data specific to HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Department of Health and Human Services Clinical Practice Guidelines

"Patients living with HIV infection often must cope with many social, psychiatric, and medical issues that are best addressed through a patient-centered, multi-disciplinary approach to the disease. The baseline evaluation should include an evaluation of the patient's readiness for ART, including an assessment of high-risk behaviors, substance abuse, social support, mental illness, comorbidities, economic factors (e.g., unstable housing), medical insurance status and adequacy of coverage, and other factors that are known to impair adherence to ART and increase the risk of HIV transmission. Once evaluated, these factors should be managed accordingly."4

Use in other federal programs

  • The Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Program for Eligible Professionals, eCQM Library, includes an Initiation and Engagement of Alcohol and Other Drug Dependence Treatment measure. However, this measure is specific to patients 13 years of age and older with a new episode of alcohol opioid, or other drug abuse or dependency. See Measure CMS137v10.

This measure is linked to an exact or similar indicator(s) within Healthy People 2030, the National HIV/AIDS Strategy (2022-2025).

References/notes

1 "Clients" includes all clients aged 13 years and older.

2 The purpose of screening is to identify past or current substance use that negatively impacts linkage to care and health care in general. A substance use screen includes documentation of past and current substance use and treatment in the HIV primary care record. Screening can be provided by any member of the multidisciplinary primary care team.

3 A "provider with prescribing privileges" is a health care professional certified in his/her jurisdiction to prescribe medications.

4 Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (PDF - 5 MB). Department of Health and Human Services. Available online. Accessed August 2023. B-1.

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