Von Korff et al developed a Chronic Disease Score (CDS) that evaluates a patient's chronic disease status based on the need for drug therapy. This can be derived using information stored in pharmacy computer databases. The authors are from the Group Health Cooperative of Puget Sound in Seattle, Washington.
|
Chronic Disease |
Medication Classes |
Points |
|
heart disease |
(1) anticoagulants, hemostatics (2) cardiac agents, ACE inhibitors (3) diuretic loop |
3 points for 1 class 4 points for 2 classes 5 points for 3 classes |
|
respiratory illness |
(1) isoproterenol (2) beta-adrenergic agent (3) xanthine products (4) respiratory products such as bronchodilators and mucolytics but excluding cromolyn (5) epinephrine |
2 points for 1 class 3 points for 2+ classes |
|
asthma, rheumatism |
glucocorticoids |
3 |
|
rheumatoid arthritis |
gold salts |
3 |
|
cancer |
antineoplastics |
3 |
|
Parkinson's |
L-dopa |
3 |
|
hypertension |
(1) antihypertensives (except ACE inhibitors) or calcium channel blockers (2) beta blockers, diuretics |
1 point if class 2 only 2 point if class 1 |
|
diabetes |
insulin, oral hypoglycemics |
2 |
|
epilepsy |
anticonvulsants |
2 |
|
asthma, rhinits |
cromolyn |
2 |
|
acne |
(1) antiacne tretinoin (2) topical macrolides |
1 point if either class with 2+ prescriptions |
|
ulcers |
cimetidine |
1 |
|
glaucoma |
ophthalmic miotics |
1 |
|
gout, hyperuricemia |
uric acid agents |
1 |
|
high cholesterol |
antilipemics |
1 |
|
migraines |
ergot derivatives |
1 |
|
tuberculosis |
antitubercular agents |
1 |
after Table 1, page 199
chronic disease score =
= SUM(points for chronic disease medications)
Interpretation:
• minimum score: 0
• maximum score: 36
• The higher the score, the more likely that the patient will be hospitalized and/or die.
Limitations:
• Some of the agents described are no longer commonly prescribed, while newer agents for treating the conditions are not listed.
• Some chronic infections like AIDS or viral hepatitis C are not represented.
Purpose: To evaluate a patient's health based on long term drug therapy using the chronic disease score of Von Korff et al.
Objective: severity, prognosis, stage
ICD-10: ,
