2020 MBHR Measure: Social Role Functioning Outcome utilizing PROMIS

QCDR Name: MBHR Mental and Behavioral Health Registry

Measure Title Social Role Functioning Outcome utilizing PROMIS
NQS Domain Effective Clinical Care
Measure ID MBHR4
NQF ID N/A
Measure Type Patient Reported Outcome (PRO)
High Priority? Yes
Description The percentage of adult patients (18 years of age or older) with a mood or anxiety disorder who report concerns related to their psychosocial function and demonstrated a response to treatment two months (+/- 30 days) after the index visit
Denominator Adult patients (18 years of age or older) with a mood or anxiety disorder who report concerns related to their psychosocial function

Denominator Exceptions: None

Denominator Exclusions Patients who die or are enrolled in hospice are excluded from this measure
Numerator The number of patients in the denominator who demonstrated a response to treatment, with a PROMIS Ability to Participate in Social Roles and Activities T score increase of 10 or greater from the index score, two months (+/- 30 days) after the index visit.

Numerator Exclusions: None

Data Source Claims, EHR, Paper Medical Record, Registry
Meaningful Measure Area Functional Outcomes
Meaningful Measure Rationale The PROMIS adult Ability to Participate in Social Roles and Activities item bank is a patient-reported outcome measure developed by NIH used to assess the perceived ability to perform oneÕs usual social roles and activities, and overal functioning.
Inverse Measure? No
Proportional Measure? Yes
Continuous Variable Measure? No
Ratio Measure No
Number of Performance Rates 1
Risk Adjusted No
Preferred Specialty mental and behavioral health
Applicable Specialties Family Practice, Internal Medicine, Geriatric Medicine, Psychiatry, Behavioral Health, Physical Therapy, Occupational Therapy, Neurology, Anesthesiology, Endocrinology, Hematology & Oncology, Neurology, Rehabilitation Medicine

Measure Justification

The World Health Organization has defined health as Òa state of physical, mental and social well-being and not merely the absence of disease or infirmityÓ (WHO, 1948). While the importance of social support to overall health outcomes has been well established (Broadhead et al., 1983; Bruhn & Philips, 1984; McDowell, 2006; Mitchell, Billings, & Moos, 1982), social health has been a domain that historically has lacked agreed definitions and measures for clinical populations (Hahn, Cella, Bode, & Hanrahan, 2010). Few measures have been developed that effectively measure outcomes across clinical disorders, or that focus on individual, non-clinical factors influencing outcomes (McQuaid, Marx, Rosen, Bufka, Tenhula,, Cook & Keane, 2012)
The Patient-Reported Outcomes Measurement Information System (PROMIS; www.nihpromis.org) adopted the World Health Organization framework to define three components of health: physical, mental and social (see http://www.nihpromis.org/measures/domainframework). The PROMIS Social Health Workgroup conducted a systematic review of social health definitions, content, and item wording, and implemented a qualitative item review process that included identification of items, development of new items, focus group exploration of domain coverage and cognitive interviews. Within the social health framework, the PROMIS social health is comprised of social function and social relationships, with the social function further divided into two domains, Ability to Participate in Social Roles and Activities (SRA), and Satisfaction with SRA.
The PROMIS adult Ability to Participate in Social Roles and Activities item bank assesses the perceived ability to perform oneÕs usual social roles and activities. Items are worded negatively in terms of perceived limitations, but responses are reverse-coded so that higher scores represent fewer limitations (better abilities). The item bank does not use a time frame (e.g. over the past seven days) when assessing ability to participate in social roles and activities.
This measure focuses on the domain of ability to participate in social roles and activities as a social health outcome that crosses diagnostic categories and treatment interventions.

Hahn EA, Cella D, Bode RK, Hanrahan RT. Measuring Social Well-being in People with Chronic Illness. Social Indicators Research. 2010;96(3):381Ð401.

Broadhead WE, Kaplan BH, James SA, Wagner EH, Schoenbach VJ, Grimson R, Heyden S, Tibblin G, Gehlbach SH. The epidemiologic evidence for a relationship between social support and health.

Am J Epidemiol. 1983 May; 117(5):521-37.
Bode RK, Hahn EA, DeVellis R, Cella D. Measuring Participation: The Patient-Reported Outcomes Measurement Information System Experience. Archives Physical Medicine Rehabilitation. 2010; 90 (9 0): S60-S65.
McQuaid JR, Marx BP, Rosen MI, Bufka LF, Tenhula W, Cook H, Keane TM. Mental Health Assessment in Rehabilitation Research. Journal of Rehabilitation Research & Development. 2012; 49 (1)