CIGNA Behavioral Health Practitioner Connection – Depression Screening in Medical Disease Management

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CBH Practitioner Conection
Volume XXIII, 3rd Quarter

The right help at the right time!

Depression Screening in Medical Disease Management

CIGNA HealthCare (CHC) offers comprehensive assessment and intensive ongoing support for persons experiencing chronic and progressive medical disorders through its medical disease management programs. Since 2000, these programs, collectively called CIGNA Well Aware for Better Health^®, have been routinely augmented by screening for depression. Screening for stress and anxiety is also now included for all populations. Depression screening is accomplished, initially and annually, using components of Pfizer Corporation’s highly validated PRIME-MD Depression Screening Inventory (the PHQ-2 and PHQ-9). Support for additional medical conditions has been progressively added, and the reach of the program has expanded each year. Performance for depression screening and intervention is measured annually. Populations receiving the depression screening in 2006 included:

Chronic Medical Conditions:

Diabetes, Cardiac Disease, Asthma, Low Back Pain, and Chronic Obstructive Pulmonary Disorder (COPD).

Targeted Medical Conditions:

Inflammatory Bowel Disease, Acid-Related Stomach Disorders, Pressure Ulcers, Atrial Fibrillation, Hepatitis C, Fibromyalgia, Osteoporosis, Irritable Bowel Syndrome, Osteoarthritis, and Urinary Incontinence.

IMPACT Conditions:

Bariatric Surgery Program, Weight Complications, and Weight Loss Wellness Program.

Those who screen positive for depression or anxiety receive intensive care management plus education, condition management, and other resource materials. Where consent is given, depression care guides, tip sheets, and other resource materials are sent to participants’ Primary Care Physicians to assist in treating depression in addition to the medical condition. Referrals to behavioral health practitioners for depression or anxiety treatment are also available. Interventions are sustained until the behavioral condition remits, and participants are monitored over time to reduce the likelihood of recurrence.

Analysis and Future Directions:

Changes in rates for depression identification can change dramatically when new medical population programs are added. A staff training initiative produced a significant increase in consent for physician notification where there is a positive screening for depression. Continued development of additional supports to the treatment of depression in the Primary Care setting is planned.

Depression Screening Reports, showing year-over-year comparison – Aggregate Well Aware Population (HMO/Flexcare and PPO)