Depression Depression MeasuresMeasuresHealth Disparities Health Disparities

Collaborative Collaborative

20052005

Important DefinitionsImportant Definitions CSD (Clinically Significant Depression) - a - a

conceptual proxy for “major depression” and is conceptual proxy for “major depression” and is defined, in operational terms, as a patient with any defined, in operational terms, as a patient with any diagnosis of depression diagnosis of depression andand a New Episode PHQ of a New Episode PHQ of 10 or greater. 10 or greater.

New Episode – the clinical determination that a – the clinical determination that a patient is suffering from depression (major, minor, patient is suffering from depression (major, minor, or dysthmia) AND that the clinical outcome of the or dysthmia) AND that the clinical outcome of the “new episode” will be monitored starting from the “new episode” will be monitored starting from the date of entry of the “New Episode PHQ.” date of entry of the “New Episode PHQ.”

New Episode PHQ - defined as the PHQ baseline - defined as the PHQ baseline score, which (along with any diagnosis of score, which (along with any diagnosis of depression) begins a new episode of depression for depression) begins a new episode of depression for which the outcome is being monitored.which the outcome is being monitored.

Core MeasuresCore Measures

MeasureMeasure GoGoalal

1.1. CSD patients with 50% reduction in PHQ (Depression symptom reduction: response)(Depression symptom reduction: response)

>40>40%%

2.2. CSD patients with a 5 point reduction in PHQ score within 6 months

(Depression symptom reduction: 6 month CSI*)(Depression symptom reduction: 6 month CSI*)

>50>50%%

3.3. CSD* patients with documented PHQ CSD* patients with documented PHQ reassessment between 4-8 weeks of last New reassessment between 4-8 weeks of last New Episode PHQEpisode PHQ

(Depression guideline treatment: early reassessment)(Depression guideline treatment: early reassessment)

>70>70%%

*CSI – Clinically Significant Improvement

Core MeasuresCore Measures

MeasureMeasure GoGoalal

4. Patients who have a diagnosis of depression and a documented PHQ score within the last 6 months

(Depression guideline treatment: 6 month reassessment)(Depression guideline treatment: 6 month reassessment)

>70>70%%

5. Depressed patients with documented self-management goal setting in the last 12 months

(Self Management)(Self Management)

>70>70%%

Additional Recommended Additional Recommended MeasuresMeasures

MeasureMeasure GoGoalal

6. CSD patients with documented early follow-up of last New Episode PHQ

(Depression guideline treatment: early follow-up)(Depression guideline treatment: early follow-up)

>70%>70%

7. CSD patients who, 4 months or longer after last New Episode PHQ, have a 50% reduction in PHQ score

(Depression symptom reduction: 4 month response)(Depression symptom reduction: 4 month response)

>50%>50%

8. CSD patients with PHQ score less than 5 at least 4 months after last New Episode PHQ

(Depression symptom reduction: 4 month remission)(Depression symptom reduction: 4 month remission)

>40%>40%

Additional Recommended Additional Recommended MeasuresMeasures

MeasureMeasure GoGoalal

9. Patients with a diagnosis of major depression or dysthymia on an antidepressant at last visit*

(Depression guideline treatment: CSD and dysthymia)(Depression guideline treatment: CSD and dysthymia)

>70>70%%

10. Patients with diagnoses of minor depression, depression NOS, or adjustment disorder (PHQ < 10) NOT on an antidepressant**

(Depression guideline treatment: minor depression)(Depression guideline treatment: minor depression)

>90>90%%

11. Depressed patients who improve in function(Depression functional improvement)(Depression functional improvement)

>40>40%% *Recommended to be used in conjunction with

measure #10

**Recommended to be used in conjunction with measure #8

Additional Recommended Additional Recommended MeasuresMeasures

MeasureMeasure GoGoalal

12. Patients with a diagnosis of major depression or dysthymia remaining on antidepressant for at least 6 months

(Depression treatment guideline: duration of antidepressant (Depression treatment guideline: duration of antidepressant medication during the continuation phase)medication during the continuation phase)

>70>70%%

13. Percent of CSD patients on an antidepressant and/or in psychotherapy within one month of last New Episode PHQ

(Depression guideline treatment: timely initiation)(Depression guideline treatment: timely initiation)

>80>80%%