Magellan Approves Clinical Practice Guidelines
Autism, GAD, OCD Guidelines Added; ADHD and Suicide Guidelines Updated
Magellan routinely reviews our existing clinical practice guidelines (CPGs) and monitors current literature to determine if adoption or development of additional guidelines is warranted. This ensures that our clinical practice guidelines conform to the current clinical knowledge and standards of practice. At least every two years, Magellan reviews its existing CPGs, while new CPGs are considered and adopted as necessary.
The review process consists of reviewing recently published scientific literature, along with available practitioner input. The CPGs developed or adopted by Magellan are living documents to be improved and refined, in light of new clinical knowledge and technology. Accordingly, practitioners’ comments are welcomed at any time.
The most recently approved or re-adopted clinical practice guidelines are detailed below.
Treatment of Patients with Attention-Deficit Hyperactivity Disorder
Earlier this year, Magellan revised the “Medications” section of our ADHD CPG to include the American Heart Association’s (AHA’s) recommendations for screening children who may be vulnerable to sudden cardiac death. Due to conflicting interpretationsof the April 2008 AHA recommendations, the American Academy of Pediatrics (AAP) and the AHA issued a joint clarification statement. Therefore, we recently revised our ADHD CPG (pages 8 and 9) to include this clarification.
Assessing and Managing the Suicidal Patient
Initially developed by Magellan in 2000, the CPG for assessing and managing the suicidal patient was reviewed in 2008 per the two-year cycle requirement. The Magellan CPG for Assessing and Managing the Suicidal Patient represents an overview of essentials and nuances to complement the American Psychiatric Association 2003 Practice Guideline for the Assessment and Treatment of Patients with Suicidal Behaviors. As such, we encourage you to become familiar with the APA document for more detail regarding any particular topic in the Magellan CPG.
View modifications to the Magellan CPG addressing issues with suicidal patients.
Treatment of Children with Autism Spectrum Disorders
To address the growing need to serve children with autism spectrum disorders, Magellan determined the importance of developing a targeted program. Initially, a CPG was needed as a foundation for product design and all clinical, claim payment and network decisions. Magellan’s Medical Services department conducted a literature search and determined to adopt the scholarly and comprehensive guideline and companion document developed by the American Academy of Pediatrics (AAP).
Magellan added two sections in its Introduction to the CPG to augment the AAP document –
- One discusses our determination in a New Technology Assessment that Applied Behavioral Analysis (ABA) is an investigational therapy, based on an evaluation of its efficacy in existing research studies.
- The other discusses the use of haloperidol with autistic children – a topic not addressed in the AAP guideline.
Guidelines to Complement CPGs for Anxiety Disorders
Magellan’s Condition Care Management program has developed a targeted approach to treating anxiety disorders. In support of this program, Magellan determined to adopt two additional CPGs:
Assessment and Treatment of Patients with Generalized Anxiety Disorder (GAD)
This guideline is a research-based document that covers the psychiatric management of patients with GAD, including psychotherapy and pharmacotherapy, clinical features and epidemiology, and treatment planning.
Its purpose is to provide an introduction, as well as a summary, of recommendations from a literature review conducted for this condition in February 2008. The rationale for this summary, which is in table format, is to avail clinicians of evidence- and consensus-based guidance on assessment and treatment of GAD in one location for ease of use and reference. However, you also should become familiar with the references cited in the document.
Treatment of Patients with Obsessive-Compulsive Disorder
The guideline Magellan has adopted to augment providers’ clinical decision-making with those members who have Obsessive-Compulsive Disorder is the American Psychiatric Association’s (APA) Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder, First Edition. This APA guideline incorporates developments in pharmacotherapy and other areas of psychiatric management of individuals with obsessive-compulsive disorder. The APA guideline is a research-based document that covers all areas of psychiatric management of patients with this disorder, from clinical features and epidemiology, to treatment approach and planning.
Provider Feedback
Magellan welcomes feedback on our clinical practice guidelines. We take all suggestions and recommendations into consideration in our ongoing review of the guidelines. Submit your comments to Kathleen Frampton at kkframpton@MagellanHealth.com.