b'POQC Pointers, continued (surfing, kayaking, climbing, etc.) across theaccessible for patients with different country and internationally. Participants justconditions. Who knew that one of the best cancer. I left feeling loved, proud of myself,need to pay their way to the site or apply forweeks of my life could be during the daily and tougher than ever!a travel scholarship to fund their travel costs.struggles of cancer? Visit firstdescents.org to First Descents is an incredible nonprofit thatThey have medical staff on site and experts inlearn more and I hope you will recommend it provides these free outdoor adventuresall the activities to make things safe andto all of your eligible patients! Value-Based Reimbursement Measure: Chemotherapy-Induced Nausea and Vomiting (CINV)Nausea and vomiting due to chemotherapyrecord. The survey results indicated that onlyMOQC has emailed each practice with the are well-known side effects of therapy, and20% of moderate emetic risk regimensVBR goal, practice-specific QOPI management via antiemetic premedicationincluded pre-populated medications (eitherperformance, survey results, and ways the has greatly reduced patient symptoms andNK1-receptor antagonists or olanzapine) as practice can modify pre-populated orders to resulting complications. Intravenousa standard premedication (range: 1347%).be consistent with national antiemetic chemotherapy is classified into four differentTo support practices in meeting the VBRguidelines and ASCO-QOPI measures. risk categories based on the likelihood oftarget for SMT28a, MOQC has developed aFor additional information, please see the vomitting or emesis occurring if noCINV page on the MOQC website. PracticesMOQC CINV webpage or email Kelly Procailo, antiemetic premedication is given: highcan review current antiemetic guidelines andPharmD, BCOP at kprocailo@moqc.org.(>90%), moderate (30-90%), low (10-30%),access helpful resources. and minimal (<10%). Guidelines for the management of chemotherapy-inducedTABLE 1. 2019 QOPI SYMPTOM/TOXICITY ANTIEMETIC MEASURESnausea and vomiting (CINV) are determinedSMT26Serotonin antagonist prescribed or administered with moderate/high emetic risk based on the risk category of thechemotherapychemotherapy regimen used.SMT27Corticosteroids and serotonin antagonist prescribed or administered with moderate/ The American Society of Clinical Oncology high emetic risk chemotherapy(ASCO)Quality Oncology Practice Initiative,SMT28NK1 receptor antagonist and olanzapine prescribed or administered with highQOPI, has developed several qualityemetic risk chemotherapymeasures to address antiemeticSMT28a*NK1 receptor antagonist (aprepitant/fosaprepitant/netupitant) or olanzapinepremedication for CINV with the intent ofadministered for low or moderate risk Cycle 1 chemotherapy (Lower scorebetter) ensuring appropriate antiemetic selection and(Top 5 test measure)reducing complications of under-prescribing,SMT29Antiemetics prescribed or administered appropriately with moderate/high emetic as well as minimizing over-prescribing inrisk chemotherapy (defect-free measure 27 and 28)scenarios where the risk does not warrantSMT29aAntiemetic therapy prescribed for highly emetogenic chemotherapy riskprophylaxis with certain antiemetics (Table 1). SMT29bAntiemetic therapy administered for highly emetogenic chemotherapy riskThe Michigan Oncology Quality ConsortiumSMT29cAntiemetic therapy prescribed for moderately emetogenic chemotherapy risk(MOQC) Measures Committee has included SMT28 and SMT28a within the MOQC MEDSMT29dAntiemetic therapy administered for moderately emetogenic chemotherapy risk ONC Track. Given a pattern of increasing use *MOQC VBR measureof prophylaxis with medications reserved for high emetic risk in the moderate and low riskFIGURE 1. NK1RA OR OLANZAPINE FOR MODERATE OR LOW EMETIC RISK CHEMOTHERAPYchemotherapy regimens, the Measures Committee selected SMT28a* as a value- 100%based reimbursement (VBR) measure 80%(Figure 1). ProportionMOQC then surveyed practices to determine60%compliance with the measures based on 40%which antiemetics were pre-populated in a selection of commonly utilized high- and moderate-risk chemotherapy regimens. Of20%the 43 practices surveyed, 32 (74%) responded, and 29 of the 32 (91%) practices02016 2017 2018indicated their antiemetic orders areTime Periodpre-populated within the electronic medical MOQCQOPI LowerisBetter2'