 | | Team Members Primary Care PhysiciansMore than half of all depression cases are treated in primary care practices. We invite our participating primary care physicians to join us in implementing an innovative strategy to enhance depression care in their practices. Aetna Depression Management is based on the Three Component Model, 3CMTM, an evidence-based depression management process. To find out more about the program and gain access to all of the tools, please take our continuing education course. Here is a general overview of the process and your role in it: Recognizing a depressed patient can be challenging. To aid you in identifying depression, Aetna Depression Management includes a series of tools to help you recognize red flags and screen for depression.  Back to topStep 2: Treatment Selection Once you have diagnosed a patient with depression, it is helpful to learn more about the patient’s problem and related symptoms. Interviewing techniques can elicit important information from the patient. You can then:
Back to topStep 3: Initial Treatment Educating patients about depression and treatment options can engage them as partners in their care. There are key educational messages for patients to understand regarding antidepressants, psychological counseling and their deteriorating condition. This is a good time to explain and recommend care management, which helps you monitor treatment response and side effects. Back to topStep 4: Care Management Process With Aetna Depression Management, the care planner monitors patient treatment compliance and communicates with you, as well as with the patient’s mental health clinician, on routine and urgent matters regarding patient care. You and the mental health clinician can expect to receive written documentation of the patient’s progress, including monthly Patient Health Questionnaire (PHQ-9) scores. You can also discuss the patient’s progress, as deemed appropriate. Back to topStep 5: Acute-Phase Physician Follow-Up You will need to determine the preferred intervals for patient visits based on:
On the initial follow-up visit, you should evaluate the patient’s response to the treatment plan and modify the treatment for any patient with a suboptimal response. The goal of acute-phase treatment is to achieve remission. Patients who do not achieve this goal remain in acute-phase treatment with some alteration in treatment. Back to topStep 6: Continuation and Maintenance Care Phase Patients who achieve remission from depression enter the continuation phase, which spans the six months after remission. There is a substantial risk of relapse during this period. Continued treatment with medications for four to nine months after remission diminishes the risk of relapse, and continued psychological counseling depends on the patient’s symptoms and psychosocial problems and on the mental health clinician’s recommendations. Because depression is a chronic disorder, educate all of your patients to recognize a recurrence. Explain to patients at risk of recurrence that there is much evidence supporting the effectiveness of long-term antidepressant maintenance treatment. Also consider periodic use of the PHQ-9 for these patients. Back to top
These guidelines are not intended to be exhaustive, nor are they intended to be prescriptive or replace your own independent medical judgment.  | | On this page:  Step 1: Recognition and DiagnosisStep 2: Treatment SelectionStep 3: Initial TreatmentStep 4: Care Management ProcessStep 5: Acute-Phase Physician Follow-UpStep 6: Continuation and Maintenance Care Phase |
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