Depression Remission or Response for Adolescents and Adults (DRR-E)
HEDIS MEASURE
Depression Remission or Response for Adolescents and Adults (DRR-E)
Line of business: Commercial Medicaid Medicare
Data Collection Method
Administrative (Claims)
Supplemental Data Submission
- Standard - Electronic Clinical Data System (ECDS) Layout
Measure Description
The percentage of members 12 years of age and older with a diagnosis of depression and an elevated PHQ-9 score, who had evidence of response or remission within 4–8 months of the elevated score.
Follow-Up PHQ-9. The percentage of members who have a follow-up PHQ-9 score documented within 4–8 months after the initial elevated PHQ-9 score.
Depression Remission. The percentage of members who achieved remission within 4–8 months after the initial elevated PHQ-9 score.
Depression Response. The percentage of members who showed response within 4–8 months after the initial elevated PHQ-9 score.
Numerator Compliance
The PHQ-9 assessment does not need to occur during a face-to-face encounter; it may be completed over the telephone or through a web-based portal.
Numerator 1—Depression Follow-Up
A PHQ-9 total score in the member’s record during the depression follow-up period.
Numerator 2—Depression Remission
Members who achieve remission of depression symptoms, as demonstrated by the most recent PHQ-9 score of <5 during the depression follow-up period.
Numerator 3—Depression Response
Members who indicate a response to treatment for depression, as demonstrated by the most recent PHQ-9 total score being at least 50 percent lower than the PHQ-9 score associated with the IESD, documented during the depression follow-up period.
Best Practices
- Educate the patient about the importance of follow-up and adherence to treatment recommendations
- Discuss the importance of timely, recommended follow-up visits
- Schedule follow-up appointments as soon as possible, particularly those patients recently discharged
- Coordinate care with behavioral health practitioners by sharing progress notes and updates
- Outreach patients who cancel appointments and assist them with rescheduling as soon as possible
- Consider telemedicine visit when in-person visits are not available
- Discuss the importance of seeking follow-up with a mental health provider
- Develop outreach internal team and/or assign care/case managers to members to ensure members keep follow-up appointments or reschedule missed appointments
- Set flags if available in EHR or develop tracking method for patients who may need screenings and follow-up visits
Quality Value Set Directory Coding Tips
44261-6 Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]
The PHQ-9 is the standard (and most commonly used) depression measure, and it ranges from 0-27 Scoring: Add up all checked boxes on PHQ-9. For every check: Not at all = 0; Several days = 1; More than half the days = 2; Nearly every day = 3 (the scores are the codes that appear in the answer list for each of the PHQ-9 problem panel terms). Interpretation: 1-4 = Minimal depression; 5-9 = Mild depression; 10- 14 = Moderate depression; 15-19 = Moderately severe depression; 20-27 = Severed depression
89204-2 Patient Health Questionnaire-9: Modified for Teens total score [Reported.PHQ.Teen]
The Patient Health Questionnaire-9: Modified for Teens (PHQ-9 Teen) total score is the sum the first of 9 items (the answers to the other 4 items are used to assess the functional impairment due to depression and screen for dysthymia and suicide risk). These 9 items are scored from 0 to 3, with higher scores indicating more severe symptoms of depression.