Clinical Practice Guidelines, Related Tools & Notifications

BlueCare Tennessee follows the Clinical Practice Guidelines (CPG) that have been adopted by BlueCross BlueShield of Tennessee. These guidelines can be viewed online via direct links found in the Health Care Practice Recommendations (HCPR) Manual. See: BlueCross BlueShield of Tennessee Clinical Practice Guidelines

BlueCare Tennessee may also follow modified Practice Guidelines based on conditions relevant to our member population, TennCare guidelines and/or nationally recognized standards in which there is not a supporting corporate guideline.

BlueCare Tennessee Practice Guidelines

Bipolar Disorder

American Psychiatric Association: Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry 2002; 159:1–50. American Psychiatric Association (2005). Guideline Watch: Practice Guideline for the Treatment of Patients with Bipolar Disorder, 2nd Edition.
http://psychiatryonline.org/guidelines.aspx

Bipolar Disorder BlueCare-specific practice guidelines

Schizophrenia

American Psychiatric Association's (APA) Practice Guideline for the Treatment of Patients With Schizophrenia, Second Edition (2004)
http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/schizophrenia.pdf

APA Guideline Watch - http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/schizophrenia-watch.pdf

Schizophrenia BlueCare-specific practice guidelines

Low Back Pain

A listing of recommendations for evaluating, diagnosing and treating Low Back Pain is available within the following website: Annals of Internal Medicine / Diagnosis and Treatment of Low Back Pain. Here we’ve provided a quick link to a copy of the Diagnosis and Treatment of Low Back Pain algorithm, which is also found in the website above.

BlueCare Tennessee CPG Related Tools

Zika Virus Information and Reporting

Learn more about the Zika virus, how to prevent mosquito bites and what mosquito repellents are safe for pregnant women from the Centers for Disease Control and Prevention.

The Zika virus has been declared a reportable disease. Visit the Tennessee Department of Health’s website to get more details and how to report a case of the Zika virus.

Recommendations for Preventive Pediatric Health Care

Guidelines are available that represent a consensus by the American Academy of Pediatrics (AAP) and Bright Futures. The AAP continues to emphasize the great importance of continuity of care in comprehensive health supervision and the need to avoid fragmentation of care. Refer to the specific guidance by age as listed in the Bright Futures guidelines (Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2008).

Prevention

The Guide to Clinical Preventive Services includes USPSTF recommendations on screening, counseling, and preventive medication topics and includes clinical considerations for each topic. See the Agency for Healthcare Research and Quality (AHRQ) and United States Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services, 2014. This new pocket guide provides general practitioners, internists, family practitioners, pediatricians, nurses, and nurse practitioners with an authoritative source for making decisions about preventive services.

Obesity

National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH), U.S. Department of Health and Human Services, Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults

This Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults is largely based on the evidence report prepared by the Expert Panel and describes how health care practitioners can provide their patients with the direction and support needed to effectively lose weight and keep it off. It provides the basic tools needed to appropriately assess and manage overweight and obesity. The guide includes practical information on dietary therapy, physical activity, and behavior therapy, while also providing guidance on the appropriate use of pharmacotherapy and surgery as treatment options.

Pharmacotherapy Management of COPD Exacerbation

The HEDIS Measure Description is as follows: The percentage of COPD exacerbations for members 40 years of age and older who had an acute inpatient discharge or emergency department encounter on or between January 1– November 30 of the measurement year and who were dispensed appropriate medications. This measure includes two rates: 1) Dispensed a systemic corticosteroid within 14 days of the event; and, 2) Dispensed a bronchodilator within 30 days of the event.

Refer to the following pages from our Clinical Practice Guidelines, Global strategy for the diagnosis, management and prevention of COPD, discussing key points and treatment options for management of exacerbations.

Manage Exacerbations: Key Points
Manage Exacerbations: Treatment Options

CPG Related Notifications

Codeine Risks in Children

Health care professionals should be aware of the risks of using codeine in children. Health professionals should consider prescribing alternative analgesics for post-operative pain control in children. There are several very good alternatives. It is also important to emphasize that all drugs have risks. Health care professionals should always weigh the benefits versus the risks before prescribing any medication. See: TennCare Drug Safety Alert to Providers 12/01/14