Abstract: . . .  years or (3) other factors judged by clinician Are Criteria met? For initial episodes of Depression (1) Taper and discontinue over 2-3 months (2) And then follow every 2 to 4 months for 8 months Yes No Developed by physicians from the Department of Psychiatry, Family Medicine and Internal Med. Based on best practice recommendations of the Agency for Healthcare Research and Quality (AHRQ) and Texas Algorithmn Project Page 2 of 2 Enter Continuation Phase Continutation Phase Treatment Recommendations 1. Medication duration: 6 - 9 months after completion of theacute phase of treatment . (Actue + Continuation =total of 9 to 12 months of treatment) 2. Practitioner Contacts: Evaluate at least once every 3 months during continuation treatment (preferably . . .
. . .  Algorithm for Diabetes) Page 27 Scott & White Health Plan Treatment Guideline: Hypertension Management in Patients with Diabetes Developed by: SWHP Diabetes Team Contact Person: Veronica Piziak, M.D. Date of Last Review: March 2004 Scheduled Review Date: March 2006 Source: American Diabetes Association Guideline Approved by SWHP Diabetes Team: March 2004 Approved by SWHP Quality Improvement Subcommittee: March 9, 2004 Only 22% of SWHP patients with diabetes achieved BP goal < 140/90 2001 study by Godley et al Choose current SWHP preferred ACEI Alternative is current SWHP preferred ARB if ACEI not tolerated If BP remains > 130/80, Start/titrate/add pharmacologic therapy ADA BP treatment goal < 130/80mmHG Page 28 Suicide risk? Bipolar? Psychotic? Alcohol . . .
. . .  based upon the best evidence currently available o Compliance must be measurable o The guideline has a clear implementation plan that includes How the guideline will be distributed and the appropriate staff educated How the guideline will be made available where clinical practice is delivered How compliance and outcomes will be measured How feedback will be provided to those using the guideline o Implementation of the guideline must be feasible throughout the Scott & White system o Guideline should improve quality • Tier #1 and Tier #2 guidelines will be routed from the developing team through the Division Director and the Department Chair (alternatively, the HP QI Committee) to the Department Managers and Clinic Board for formal endorsement before . . .
. . .  8 months Yes No Developed by physicians from the Department of Psychiatry, Family Medicine and Internal Med. Based on best practice recommendations of the Agency for Healthcare Research and Quality (AHRQ) and Texas Algorithmn Project Page 2 of 2 Enter Continuation Phase Continutation Phase Treatment Recommendations 1. Medication duration: 6 - 9 months after completion of theacute phase of treatment . (Actue + Continuation =total of 9 to 12 months of treatment) 2. Practitioner Contacts: Evaluate at least once every 3 months during continuation treatment (preferably 1-2 months) Continued Good Response? Return to Acute Phase No Yes Treatment Ends Maintenance Continueat full doses Duration may be: a) 1 year b) 2 to 5 years c) Lifetime Page 30 Population: . . .
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