Practice Guidelines
Guideline Adoption and Recommended Use
PacificSource adopts guidelines to assist providers and members in making decisions about appropriate healthcare. Derived from nationally recognized sources, these guidelines are based on recent medical evidence and/or consensus among physicians regarding clinical treatment patterns. They are not intended to be a substitute for professional medical advice.
In all cases, benefit determinations should be based on the applicable contract coverage. Should there be any discrepency between these guidelines and the contract language, the contract language will take precedence.
Asthma
2007 Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma - National Heart Lung and Blood Institute, 2007
Alcohol abuse screenings and references
Alcohol Use Disorders Identification Test (AUDIT) - Interview Form - PacificSource covers the use of this screening tool. Please use CPT code 99408.
Alcohol Use Disorders Identification Test (AUDIT) - Self-Report Form
AUDIT: Guidelines for Use in Primary Care, Second Edition (PDF) - World Health Organization, Department of Mental Health and Substance Dependence
A Pocket Guide for Alcohol Screening and Brief Intervention - National Institute on Alcohol Abuse and Alcoholism, 2005
National Institute on Alcohol Abuse and Alcoholism (NIAA) Web site
Alcohol Alert from the NIAAA: Publications - National Institute on Alcohol Abuse and Alcoholism, 2005
Helping Patients Who Drink Too Much: A Clinician’s Guide - National Institute on Alcohol Abuse and Alcoholism, 2005, updated in 2007
Oregon Healthy Teens Survey - Questionnaire (8th & 11th grade versions) about alcohol, drug and nicotine use.
Behavioral health and chemical dependency
Practice Guidelines - American Psychiatric Association
Guidelines for Adolescent Depression in Primary Care (GLAD-PC) Toolkit - AHRQ Healthcare Innovations Exchange
Coronary artery disease
Stable Coronary Artery Disease - Institute for Clinical Systems Improvement, April 2011
COPD
A Guide to COPD Diagnosis, Management, and Prevention, Updated 2010 - Global Initiative For Chronic Obstructive Lung Disease
Depression screening and references
American Psychiatric Association Practice Guidelines for Treatment of Patients with Major Depressive Disorder
The MacArthur Initiative on Depression and Primary Care Tool Kit
Patient Health Questionnaire (PHQ9) Overview
Diabetes - Adult
Standards of Medical Care in Diabetes 2012 - American Diabetes Association, 2012
Medical Guidelines for Clinical Practice for Developing a Diabetes Mellitus Comprehensive Care Plan - American Association of Clinical Endocrinologist, 2011
Pre-Diabetes: Guidelines on Diabetes, Pre-Diabetes, and Cardiovascular Disease, 2007 - AHRQ Task Force on Diabetes and Cardiovascular Diseases
Diabetes - Child and Adolescent
Care of Children and Adolescents With Type I Diabetes, ADA, January, 2005
Heart Failure
2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults - Circulation: Journal of the American Heart Association, 2009
Hyperlipidemia
Lipid Management for Adults - Institute for Clinical Systems Improvement (ICIS), Twelfth Edition, October 2011
Hypertension
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and
Treatment of High Blood Pressure, National Heart Lung and Blood Institute, December 2003
Immunizations and screenings
Screening for Lipid Disorders in Adults – AHRQ, June 2008
Recommended Child & Adolescent Immunization Schedules Ages 0 to 6 - CDC, 2012
Recommended Child & Adolescent Immunization Schedules Ages 7 to 18 - CDC, 2012
Catch up schedule - CDC, 2012
Recommended Adult Immunization Schedule - CDC, 2012
Selected Preventive Screening Recommendations - CDC, 2010
Metabolic Syndrome – Adult
Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement, September 2005
Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline, October 2008
Metabolic Syndrome - Children and Adolescent
Progress and Challenges in Metabolic Syndrome in Children and Adolescents: A Scientific Statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism, 2009
Obesity - Adult
Prevention and Management of Obesity (Mature Adolescents and Adults) - Institute for Clinical Systems Improvement (ICIS), April 2011
Obesity - Pediatric
Prevention and Treatment of Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion, December 2008
Dietary Recommendations for Healthy Children - American Heart Association, 2012