BOX 6-3
Sample of Triggers for Outpatient Adverse Drug Events

In the case of an outpatient taking a diuretic, the following adverse reactions (and their synonyms) would serve as triggers for detection of a potential ADE:

  • Dizziness (also syncope, lightheaded, vertigo, “wooziness”)

  • Fainting (also blackout, loss of consciousness, syncope or near syncope, vagal reaction, vasometer collapse, vasovagal reaction, “swooning”)

  • Fall(s)

  • Fatigue (also drowsiness, drowsy, lassitude, lethargic, lethargy, listless, listlessness, malaise, tired)

  • Hypokolemia (also low potassium, muscle cramps, potassium decreased, potassium deficiency)

  • Hyponatremia (also low serum sodium)

  • Hypotension (also arterial blood pressure decreased, low blood pressure, postural hypotension)

  • Renal failure (also kidney shutdown, chronic renal insufficiency)

  • Weakness (also decreased muscle strength, lack of strength)

SOURCE: Bates, 2002.

DQIP has developed a core set of evidence-based measures1 for assessing the quality of adult diabetes care. These measures are used to monitor the progress of individual patients and groups of patients with diabetes as they pass through the care process.

The measures include those used for external accountability and internal quality improvement. The core set for accountability encompasses measures in seven areas of outpatient care: hemoglobin A1C (HbA1C) management, lipid management, urine protein testing, eye examination, foot examination, blood pressure management, and smoking cessation. The set for quality improvement includes measures in these seven areas and in two additional areas—influenza immunization and aspirin use.


These performance measures were initially developed by the Centers for Medicare and Medicaid Services, the Foundation for Accountability, the American Diabetes Association, and the National Committee for Quality Assurance. In 2002, DQIP merged with a performance collaboration of the American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations, and the National Committee for Quality Assurance to form the National Diabetes Quality Improvement Alliance.

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