91������

91������ supports NQF 0036 with modifications: “Use of Appropriate Medications for People with Asthma (ASM).” Appropriate medication management for patients with asthma can prevent, and in some cases reverse the disease process. Evidence shows that therapeutic approaches allow most people who have asthma to participate fully in activities they choose. 91������ supports this measure with modifications because the numerator specifications include medications that are not commonly used in practice such as theophylline, potassium iodide, and guaifenesin. Although sustained release theophylline is a mild to moderate bronchodilator, it is used as a non-preferred adjunctive alternative therapy to inhaled corticosteroids. If theophylline is prescribed as adjunctive therapy, providers should document patient exclusions for alternative treatment and monitor its serum concentration. Additionally, while this measure is straight forward to calculate at the health plan level for patients with pharmacy benefits, it will be more difficult to calculate at the physician group level without medical record review.