Quality Management Information for Providers
Education and Treatment Compliance for Adults with Major Depressive Disorder
QUEST BEHAVIORAL HEALTH (QUEST) offers a preventive health program for individuals who have recently been diagnosed with Major Depressive Disorder (MDD) and are being treated with psychotherapy and/or antidepressant medication. This program is designed to improve clinical outcomes for these individuals by educating them about depression and its symptoms, available treatments, the course of recovery, and by helping them understand critical aspects of their own role in the treatment process.
This educational program is designed to complement the care you provide. Together with your support, QUEST can help its members receiving treatment for MDD become informed consumers of health care, actively involved in their own treatment. It is our hope that the educational materials will help patients understand the importance of communicating with their providers and increase treatment compliance. Treatment compliance and communication about treatment issues are critical to helping individuals overcome their depression in a timely and effective manner.
The information in this overview will help you understand the program and how you can assist us in this important preventive health initiative which we believe can have a positive impact for our members under your care.
Why has QUEST implemented this program?
Depression is the most common diagnosis among adults between the ages of 18 and 64 among QUEST'S membership. Antidepressant medications are now frequently prescribed alone, or in combination, as a first line treatment for depression. Many individuals also participate in psychotherapy for depression. For both of these treatment approaches, compliance issues and patient behavior in relation to the treatment can pose major barriers in an otherwise highly effective treatment regimen.
QUEST BEHAVIORAL HEALTH views the role of educating patients about the treatment process, helping them understand their experience of treatment, and encouraging them to assume an active role in their treatment as factors critical to ensuring effective treatment and preventing relapse. This program helps patients understand the course of treatment, how the treatments work, and what kind of effects they might anticipate. The program emphasizes communication with providers and educates patients about self-care during treatment and recovery. Helping patients understand their role in the treatment process can have a positive impact on the treatment of depression, aiding in their return to baseline levels of functioning at work and at home.
What are the goals of QUEST'S program?
The goals of this program are to:
- Educate members about depression.
- Help patients identify symptoms to track improvement over the course of treatment.
- Educate members about how antidepressants work.
- Educate members about psychotherapy.
- Help members understand what they can expect from treatment.
- Help members anticipate the effects of antidepressant medications and the side-effects they may encounter.
- Help members understand the importance of participation in and compliance with psychotherapy.
- Encourage members to communicate with their providers about their treatment.
- Instruct members in ways they can improve their recovery from depression.
What are the criteria for member inclusion in this program?
This program is designed for members ages 18 and over who have been diagnosed with a depressive disorder (DSM-IV codes: 296.3, 296.3, 300.4 and 311) as a primary or secondary Axis I diagnosis and who have been prescribed antidepressant medications and/or are being treated with psychotherapy. This program is not intended for individuals who have been diagnosed with Bipolar disorders and other mood disorders not indicated by the codes listed above.
What interventions does the program include?
This program consists of three educational newsletters, which will be mailed to members who recently received authorization for medication management and/or psychotherapy, and for whom authorization data indicate a diagnosis of a depressive disorder. Copies of all three newsletters are included with this overview. We encourage you to review them.
The first newsletter focuses on basic information about depression and helps patients to identify symptoms they are experiencing. This information is designed to help patients develop a vocabulary to discuss or describe their feelings and any changes in symptoms during treatment. This module also introduces patients to important aspects of their care-types of psychotherapy treatment approaches, how their medication was chosen, and basic information about side-effects.
The second newsletter emphasizes ways in which patients can make the most of treatment. This includes further information about medications including a discussion of the symptoms which are most responsive to antidepressants, common side effects which they may experience, and how they can work with their provider to balance the positive and negative effects of their medications. Similarly, patients are provided information about how to optimize their psychotherapy treatment. In this regard, the newsletter addresses several components of psychotherapy process critical to effective treatment. Finally, patients are introduced to self-care issues relevant to making changes outside of treatment which can facilitate symptom remission.
The third newsletter educates members about the process of recovery from depression, treatment continuation and maintenance. It also elaborates on self-care issues important in recovering and maintaining improvement after treatment.
How will this program be evaluated?
A sample of individuals participating in the program will be contacted by telephone or mail and asked to complete a brief survey assessing their perceptions of the usefulness of this program. Over time, additional evaluation strategies may be added such as asking participating patient s to complete a medication compliance inventory or tracking data on treatment continuation or losses to follow-up using QUEST'S claims data.
How will this program be made available to members?
At least annually, QUEST will inform its members about this preventive behavioral health program. This information will be communicated to members through member newsletters, materials mailed along with authorization letters or by asking you to make materials available in your office. Members will be encouraged to take advantage of the program and will be told how to obtain the materials. Members who meet diagnostic eligibility criteria based on authorization and treatment plan data will automatically receive an introductory letter describing the program and information on how to opt out of the program if they desire.
The educational modules described above will be mailed out to participating members. Following the introductory letter, newsletters will be mailed out at four week intervals. If members choose not to participate in the program or wish have the newsletters sent to a different address they can call a toll-free number.
What can you do as a provider?
QUEST'S prevention program is designed to increase the patient's awareness of the important role he or she plays in the effective treatment of their depression. Your support for this program is important to us. While QUEST will contact members automatically through the identification processes discussed above, you are encouraged to inform members about this program and to call us with the name of any member who meets the inclusion criteria.
Participating members may seek additional information from you or have questions regarding the issues discussed in the educational materials. We've included depression information that we request you copy and distribute to member's who meet the criteria for inclusion in the program. We hope that this will positively influence your treatment relationship and assist you caring for your patient.
Included with this program description are copies of the introductory letter and the three educational newsletters that will be mailed to members participating in the program. Please take the time to read these materials and give us your feedback. It is our hope that you find these materials a valuable addition to the care you provide. Should you have any questions or concerns, we would be pleased to address them. To discuss the program, please contact Quality Management at 1-800-364-6352.
