AHRQ Comparative Effectiveness Reviews Help Massachusetts Refine Medicaid Clinical Policy
As a result of participation in the Medicaid Medical Directors' Learning Network, an AHRQ Knowledge Transfer project, the Massachusetts Medicaid Office of Clinical Affairs used several AHRQ Comparative Effectiveness Reviews to refine clinical policy.
Roger Snow, MD, MPH, Deputy Medical Director for the Massachusetts Medicaid Office of Clinical Affairs, used the Comparative Effectiveness Review, Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression, to develop drug-specific guidelines for Medicaid beneficiaries. These guidelines help the Office of Clinical Affairs ensure that the prescribing of antidepressant medications is appropriate.
The AHRQ review summarizes the literature on adult use of second-generation antidepressants, comparing the drugs' benefits and risks in the treatment of major depressive disorder, dysthymia, and subsyndromal depression. The report notes that second-generation antidepressants, which include selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, are often prescribed because first-generation antidepressants can cause intolerable side effects and carry high risks. Such findings led Massachusetts to revise its prescribing guidelines that favored first-generation antidepressants.
Snow also found the Comparative Effectiveness Review, Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities, to be helpful. The review helped his team determine when a suspicious mammogram should be followed up with a breast MRI and when a biopsy would be more likely to find cancer.
Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression, January 2007. Comparative Effectiveness Review No. 7. Agency for Healthcare Research and Quality, Rockville, MD.
Effectiveness of Noninvasive Diagnostic Tests for Breast Abnormalities, February 2006. Comparative Effectiveness Review No. 2. Agency for Healthcare Research and Quality, Rockville, MD.