DESCRIPTION:

The percentage of adolescent patients 12 to 17 years of age and adult patients 18 years of age or older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event.

IMPROVEMENT NOTATION:

Higher score indicates better quality

INITIAL POPULATION:

Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event. 

DENOMINATOR:

Equals Initial Population

DENOMINATOR EXCLUSIONS:

Patients with a diagnosis of bipolar disorder 

Patients with a diagnosis of personality disorder 

Patients with a diagnosis of schizophrenia or psychotic disorder

Patients with a diagnosis of pervasive developmental disorder Patients who were permanent nursing home residents  

DENOMINATOR EXCEPTIONS:

None

NUMERATOR:

Adolescent patients 12 to 17 years of age and adult patients 18 years of age and older who achieved remission at twelve months as demonstrated by a twelve month (+/- 60 days) PHQ-9 or PHQ-9M score of less than five.

NUMERATOR EXCLUSIONS:

Not Applicable



DEFINITION:

Denominator Identification Period - The period in which eligible patients can have an index event. The denominator identification period occurs prior to the measurement period and is defined as 14 months to two months prior to the start of the measurement period. The denominator identification period is from 11/1/2017 to 10/31/2018. For patients with an index event, there needs to be enough time following index for the patients to have the opportunity to reach remission twelve months +/- 60 days after the index event date.

Index Event Date - The date in which the first instance of elevated PHQ-9 or PHQ-9M greater than nine AND diagnosis of depression or dysthymia occurs during the denominator identification measurement period (11/1/2017 to 10/31/2018).  

Measure Assessment Period - The index event date marks the start of the measurement assessment period for each patient which is 14 months (12 months +/- 60 days) in length to allow for a follow-up PHQ-9 or PHQ-9M between 10 and 14 months following the index event. This assessment period is fixed and does not “start over” with a higher PHQ-9 or PHQ-9M that may occur after the index event date. 

Remission - Is defined as a PHQ-9 or PHQ-9M score of less than five.

Twelve Months - Is defined as the point in time from the index event date extending out twelve months and then allowing a grace period of sixty days prior to and sixty days after this date. The most recent PHQ-9 or PHQ-9M score less than five obtained during this four month period is deemed as remission at twelve months, values obtained prior to or after this period are not counted as numerator compliant (remission).