Given the prevalence of clinical depression in the United States — 6.7 percent of adults had at least one major depressive episode in 2013, according to the National Institute of Mental Health — it is vital for primary care physicians to appropriately screen patients suspected of having a depressive disorder to determine the severity and the most suitable treatment plan.
Depending on the frequency and severity of the depressive symptoms present, some patients may require antidepressant medications or a combination of antidepressants and psychotherapy, while others may benefit most from psychotherapy alone.
HEDIS Depression Care Measures Set
The National Committee for Quality Assurance (NCQA) recently released a set of three HEDIS measures addressing depression screening, care, and outcomes in adolescents and adults:
- Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
- Depression Remission, Response or Treatment Adjustment for Adolescents and Adults
- Depression Screening and Follow-up for Adolescents and Adults
The measures aim to determine whether members of health plans like Harvard Pilgrim get screened appropriately for depression, and if they receive care that leads to improved outcomes.
PHQ-9 as a depression screening tool
The Patient Health Questionnaire (PHQ-9) is a reliable, efficient tool for assessing and monitoring the severity of depression in behavioral health patients, serving as a strong base for diagnosis and coordination of follow-up care. The questionnaire, which can be completed by the patient in minutes, rates the frequency of depressive symptoms. A non-scored follow-up question on the PHQ-9 assesses the degree to which the patient’s depression has affected his or her level of function.
The treating physician can score the results of the questionnaire rapidly, and can administer the PHQ-9 multiple times throughout the course of treatment to monitor improvement or worsening of depressive symptoms.
The role of the PCP and referrals for follow-up care
Primary care physicians play an important role in identifying and treating depression, appropriately screening patients using the PHQ-9 and using the findings to develop a comprehensive treatment plan. The care for a patient diagnosed with depression may involve collaboration between the PCP and behavioral health practitioners, and may consist of referring the patient for psychotherapy, prescribing antidepressants, or a combination of elements.
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 at 888-777-4742.