Help Improve Member Compliance with Anti-Depressant Medication
While most patients think they are “compliant” in taking their anti-depressant medications, studies have shown that 42 percent of patients taking an anti-depressant will become non-compliant with medication within the first 30 days. A total of 72 percent of patients will become non-compliant before 90 days1.
For members identified and diagnosed with a new episode of major depressive disorder (MDD), and who are being treated with anti-depressant medication, Magellan monitors the following:
- Practitioner Contacts – Each member should have at least three follow-up contacts with a practitioner within 84 days of receiving the diagnosis and initial prescription. (2007 Northeast Care Management Center data indicates that this occurs in only 28 percent of cases.) One of the three visits must be with the prescribing physician.
- Acute Phase Treatment – Each member who remains on anti-depressant medication during the initial 84 days after a MDD diagnosis should be re-assessed.
- Continuation Phase Treatment – Each member who remains on anti-depressant medication for at least 180 days should be re-assessed.
Continuing to monitor the member throughout the course of treatment is essential. You should determine the monitoring frequency by the severity of illness, the member’s understanding and compliance with treatment, availability of social and community resources, and co-morbid medical conditions. Please remember to do the following:
- Involve the member in choice of medications prescribed when possible.
- Document member understanding of the rationale for medication use. We found documentation in only 48 percent of treatment records reviewed in 2007.
- Educate the member on risks and benefits of the medication, including major side effects. We found this documentation in only 68 percent of treatment records reviewed in 2007.
- Document the member’s understanding of the rationale for medication use.
- Encourage the member to contact you if they are experiencing side effects.
- Ensure the member is seen for follow-up appointments.
- Re-evaluate the member as needed.
Please also take into account and document other practitioners whom the member is seeing. If the member is being treated by multiple providers, obtain the appropriate authorization to communicate with those providers.
If you have any questions or concerns, call Magellan at 1-800-435-7670, ext. 52937.
1Managing Compliance, Richard Balon, MD Psychiatric Times, May 1, 2002.