In recent years, the process of developing clinical practice guidelines has undergone significant re-evaluation by national professional organizations including the American Medical Association and the Institute of Medicine. With an eye toward increasing rigor and improving transparency, these organizations have articulated principles that form the foundation for new standards of guideline development. The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) have both published statements on their websites in support of these new standards.
Historically Beacon Health Options, Inc. (Beacon) and its legacy companies adopted clinical practice guidelines published by the APA, AACAP and other professional organizations. This was based on their reputation as primary contributors and developers of guidelines representing acceptable standards of care at the time of origination.
Related to the continued evolution of clinical practice guideline development calling for higher standards of evidence, the industry currently has maintained or produced a limited number of guidelines that meet the new standards for guideline rigor and transparency. Accordingly, Beacon has reviewed and adopted the following guidelines that meet those standards:
- The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia
- The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults
- The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use
- CDC Guideline for Prescribing Opioids for Chronic Pain – United States, 2016 (adopted by Beacon as treatment recommendation for primary care or pain specialty practitioners)
- The ASAM Consensus Statement – Appropriate Use of Drug Testing in Clinical Addiction Medicine
Clinical practice guidelines that were developed prior to the implementation of the revised guideline development standards and previously adopted by Beacon are provided below. Although not meeting the highest evidentiary formulation standards, these guidelines still contain information that continues to be clinically relevant. For example, some of the guidelines may recommend specific treatment interventions without adequately addressing the sufficiency of the evidence to support the recommendation. Continued use of the guidelines is warranted because resultant positive clinical contribution outweighs the fact that the summaries of the supporting research may have lacked adequate transparency related to the process of ranking the studies necessary to meet today’s standards of guideline development. Practices represented in these guidelines often are validated as the community standard of care but the rigorous scientific research confirmation is still in process.
In sum, we find the CPGs being utilized represent the best clinical information we have at this time. Until such time that updated information is developed, the CPGs are appropriate for use where applicable.
Anxiety Disorders
- Acute Stress Disorder and Post-Traumatic Stress Disorder
Adopted from APA Reviewed 03/21/17 - Acute Stress Disorder and Posttraumatic Stress Disorder Guideline Watch
Adopted 05/21/12 Reviewed 03/21/17 - Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder
Adopted 03/21/17 - AACAP Practice Parameters for the Assessment and Treatment of Children and Adolescents with Anxiety Disorders
Reviewed 02/21/17 - Generalized Anxiety Disorder – Adults
Adopted from Canadian Psychiatric Association Anxiety Guidelines
Reviewed 03/21/17 - Treating Panic Disorder – APA Practice Guideline
Reviewed 02/21/17 - Treating Panic Disorders APA Practice Guideline Quick Reference Guide
Reviewed 02/21/17 - Panic Disorder Overview
Adopted from NICE 06/16/15 Reviewed 02/21/17
Assessment of Suicide Risk
- Assessment of Suicide Risk APA Guideline III
Adopted 04/19/16 Reviewed 02/20/18
Attention-Deficit Disorder
- AAP ADHD Clinical Practice Guidelines for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents
Adopted 02/21/17 - AACAP Practice Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder
Reviewed 03/21/17 - AAP Clinical Practice Pathways for Evaluation and Medication Choice for Attention-Deficit/Hyperactivity Disorder Symptoms in Autism Spectrum Disorders
Adopted 02/17/15 Reviewed 03/21/17
Autism Spectrum Disorders (ASD)
- AACAP Practice Parameter for the Assessment and Treatment for Children-Adolescents with ASD
Adopted 08/18/14 Reviewed 02/21/17 - AAP Management of Children with ASD Reviewed 02/21/17
- AAP Identification and Evaluation of Children with ASD Reviewed 02/21/17
Eating Disorders
- AACAP Practice Parameters for Eating Disorders
Adopted 12/20/16 - Eating Disorders – APA Guideline
Reviewed 03/21/17 - Eating Disorders APA Practice Guideline Watch
Adopted 04/15/13 Reviewed 03/21/17
Mood Disorders
- ICSI – Major Depression in Adults in Primary Care Guideline and Executive Summary
Reviewed 12/20/16 - Major Depression
Published from the APA 10/2010 Reviewed 04/18/17 - AACAP Practice Parameter for Assessment and Treatment of Children and Adolescents with Depressive Disorders
Adopted 05/19/14 Reviewed 03/21/17 - VA/DoD Management of Bipolar Disorder (BD) in Adults
Published 05/2010 Reviewed 04/18/17 - AACAP Practice Parameter for the Assessment and Treatment of Children and Adolescents with Bipolar Disorder
Published 01/2007 Reviewed 04/18/17 - The Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) Collaborative Update of CANMAT Guidelines for the Management of Patients with Bipolar Disorder
Published 2013 Reviewed 04/18/17 - NICE – Bipolar Disorder: Assessment and Management Clinical Guideline
Published 09/2014 Reviewed 04/18/17
Psychotic Disorders
- APA Practice Guideline for the Treatment of Patients with Schizophrenia
Published 02/2004 Reviewed 04/18/17 - APA Guideline Watch: Practice Guideline for the Treatment of Patients with Schizophrenia
Published 09/2009 Reviewed 04/18/17 - APA Treating Schizophrenia – A Quick Reference Guide
Published 02/2004 Reviewed 04/18/17 - AACAP Practice Parameter for the Assessment and Treatment of Children and Adolescents with Schizophrenia
Published 09/2013 Reviewed 04/18/17
Substance Use Disorders (SUD)
- SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants
Published 2018 Reviewed 05/15/18 - CDC Guideline for Prescribing Opioids for Chronic Pain – United States, 2016 (adopted by Beacon as treatment recommendation for primary care or pain specialty practitioners)
Reviewed 03/20/18 - ASAM Consensus Statement – Appropriate Use of Drug Testing in Clinical Addiction Medicine
Adopted 12/19/17 - VA/DoD Clinical Practice Guideline for Management of Substance Use Disorders (SUD)
Adopted 2015 Reviewed 05/16/17 - SAMHSA Tip 42 Co-Occurring Disorders
Adopted 06/16/14 Reviewed 06/20/17 - Facing Addiction in American – The Surgeon General’s Report on Alcohol, Drugs, and Health
Reviewed 06/20/17 - AACAP Practice Parameter for the Assessment and Treatment of Children and Adolescents With Substance Use Disorders
Adopted 10/20/14 Reviewed 02/21/17 - Medication-Assisted Treatment for Opioid Addiction – SAMHSA Tip 43
Reviewed 05/16/17 - ASAM National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use
Adopted 09/13/16 Reviewed 07/17/18 - ASAM Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use Synopsis
Adopted 05/17/16 Reviewed 07/17/18 - Supplemental Information from NIH
Adopted 05/17/16 Reviewed 07/17/18 - Methadone Safety: A Clinical Practice Guideline from the American Pain Society and College on Problems of Drug Dependence, in Collaboration with the Heart Rhythm Society
Adopted 09/20/16 Reviewed 07/17/18 - APA Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder
Adopted 2/20/18
Special Topic Guidelines
- Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia – APA
Adopted 08/16/16 Reviewed 7/17/18 - APA Summary – Use of Antipsychotics to Treat Agitation or Psychosis in Patients with Dementia
Adopted 08/16/16 Reviewed 7/17/18 - Employee Assistance Program (EAP) Guidelines
Published 2010 Reviewed 02/21/17 - Telemental Health Guidelines – ATA
Published 10/10 Reviewed 04/18/17 - ATA Practice Guidelines for Video-Based Online Mental Health Services
Adopted 07/21/14 Reviewed 04/18/17 - APA Psychiatric Evaluation of Adults SRC 2-9-18 CMMC 2-20-18
Reviewed 02/20/18 - AACAP Clinical Update: Telepsychiatry with Children and Adolescents
Published 10/2017 Adopted: 4/17/18
Screening Instruments
- Supplement: Columbia-Suicide Severity Rating Scales (C-SSRS’s)
Adopted 04/19/16 Reviewed 03/20/18 - Screening for Depression in Children & Adolescents (US Preventative Services Task Force)
Adopted 03/21/17
The Beacon Health Options Scientific Review Committee (SRC) reviews and/or updates each guideline at least every two years. In addition, if the original source of the guideline publishes an update or makes a change, the SRC will initiate additional review of the guideline prior to the two-year review cycle. Updates/changes are then presented to the Beacon Health Options Corporate Medical Management Committee for final approval. Please note that the SRC completes literature reviews as part of this process and at times will adopt/re-adopt a guideline that is more than five years old if it is determined that it remains a best practice and an industry standard of care.