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Antidepressant Medication Management (AMM)

HEDIS Measure

Antidepressant Medication Management (AMM)

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative

Measure Description

The percentage of members 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment. Two rates:

  • Effective Acute Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 84 days (12 weeks).
  • Effective Continuation Phase Treatment. The percentage of members who remained on an antidepressant medication for at least 180 days (6 months).

Numerator Compliance

Effective Acute Phase Treatment - At least 84 days (12 weeks) of treatment with antidepressant medication beginning on the IPSD through 114 days after the IPSD (115 total days). This allows gaps in medication treatment up to a total of 31 days during the 115-day period. Gaps can include either washout period gaps to change medication or treatment gaps to refill the same medication.

Effective Continuation Phase Treatment - At least 180 days (6 months) of treatment with antidepressant medication, beginning on the IPSD through 231 days after the IPSD (232 total days). This allows gaps in medication treatment up to a total of 52 days during the 232-day period. Gaps can include either washout period gaps to change medication or treatment gaps to refill the same medication.

IPSD - Index prescription start date. The earliest prescription dispensing date for any statin medication of any intensity during the measurement year.

Best Practices

  • Discuss with patients the importance of taking medication as prescribed and remaining on medication for a minimum of six months even when the patient starts to feel better
  • Discuss with patients the risks of stopping medication before six months or abruptly and recommend follow-up first for a consultation
  • Educate patients on possible side effects and length of time for the medication to have the desired effect
  • Schedule follow up appointment before the patients leaves office and send appointment reminders
  • Develop tracking method for patients prescribed antidepressants and require staff to follow up with patients that miss or cancel their appointment
  • When available, use gap lists to help manage your total population
  • Consider the patient's work schedule as a barrier to the visit, and offer extended evening, weekend hours or telemedicine

Antidepressant Medications

Description Prescriptions
Miscellaneous antidepressants Bupropion, Vilazodone, Vortioxetine
Monoamine oxidase inhibitors Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine
Phenylpiperazine antidepressants Nefazodone, Trazodone
Psychotherapeutic combinations Amitriptyline-chlordiazepoxide, Amitriptyline-perphenazine, Fluoxetine-olanzapine
SNRI antidepressants Desvenlafaxine, Duloxetine, Levomilnacipran, Venlafaxine
SSRI antidepressants Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline
Tetracyclic antidepressants Maprotiline, Mirtazapine
Tricyclic antidepressants Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin (>6 mg), Imipramine, Nortriptyline, Protriptyline, Trimipramine