When treating patients with signs of depression, mental health experts recommend that you begin by using a nationally recognized depression screening tool. Harvard Pilgrim provides clinical tools for PCPs — including the Patient Health Questionnaire (PHQ-9), a nine-question screening tool used to measure the severity of depression — that provide an analytical framework for the evaluation and treatment of common problems. In addition to using the PHQ-9, please complete a comprehensive medical exam including lab testing, which may identify metabolic causes of depression.
If you have determined that your patient has depression, a best practice for the treatment of patients with major depressive disorder includes a treatment plan involving:
- Psychotherapy (such as individual, family, group, cognitive behavioral) and
- Medication for moderate to severe depression (a score of 10 or greater on PHQ-9 screening tool)
It’s also important to reinforce with your patients that mental health issues can be successfully treated by adhering to their treatment plan. The American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Major Depressive Disorder elaborates on best practice treatment.
Antidepressant Medication Management
The National Committee for Quality Assurance (NCQA) publishes health plan HEDIS rates for adult patients who are diagnosed with major depression and are started on an antidepressant medication. To reduce the risk of relapse (and to be compliant with the HEDIS measure), patients should remain on an antidepressant drug for at least 180 days (six months). Additionally, best practice guidelines suggest that you discuss with patients that it may take 10 to 12 weeks for the full effect of the medication to be felt.
Strategies for encouraging patients to continue with antidepressant treatment:
- Providing education on how antidepressants work and how long they should be used
- Explaining the benefits of the treatment
- Identifying ways to eliminate or manage side effects of the medication
- Discussing expectations regarding the remission of symptoms
- Encouraging patients to make an appointment if they have any questions or are considering stopping medication
How Optum/UBH can help your patients. For complex clinical situations, Optum/UBH is available to provide consultative assistance. Practitioners can call the Optum/UBH Physicians Consultation Service at 800-292-2922. To refer a patient for behavioral health services and to facilitate the coordination of care, call Optum/UBH at 888-777-4742.