Antidepressant Medication Adherence (AMM) Medicaid

September 28, 2022

Major Depression is one of the most common mental illnesses, affecting 8.4% (more than 20 million) American adults each year¹. While it is a treatable disorder, many individuals fail to seek treatment or end treatment prematurely.

How You Can Help Close Gaps in Care

As part of monitoring quality of care, we track Antidepressant Medication Management (AMM). AMM is a Healthcare Effectiveness Data and Information Set (HEDIS®) measure from the National Committee for Quality Assurance (NCQA).²  AMM assesses medication adherence for members 18 years of age and older who have a diagnosis of major depression and have been treated with antidepressant medication.

AMM captures two stages of medication adherence:

• Effective Acute Phase Treatment: Newly treated with antidepressant medication and remained on an antidepressant medication for at least 84 days (12 weeks).
• Effective Continuation Phase Treatment: Newly treated with antidepressant medication and remained on an antidepressant medication for at least 180 days (6 months).

Reasons Why Patients Discontinue Medications

There can be a variety of reasons, including the following:

• The patient does not feel better quickly
• Side effects of the medication
• The medication costs too much
• The patient forgets to take the medication consistently
• The patient starts feeling better and thinks the medication is no longer needed
• The stigma associated with taking medication for depression
• The patient takes multiple medications already

Tips to Consider

Below are a few tips you may want to use when talking to your patients about taking antidepressants:

• If the patient is not taking the medication, find out the reason behind the non-compliance.
• Assess if the patient is using any substances (drugs or alcohol) that could be interfering with the medication.
• Help the patient problem-solve any cost issues for the medication.
• Encourage the patient to set a reminder or an alarm to take the medication.
• Assist the patient in developing a medication adherence plan, especially if the patient already takes multiple medications. A chart may assist the patient in keeping track of everything.
• Consider referring the patient to a mental health practitioner who specializes in depression.

References and Resources

• Tip sheet regarding medical record documentation and best practices for the AMM measures
• Substance Abuse and Mental Health Services Administration’s 2020 National Survey of Drug Use and Health                                     
• NCQA AMM HEDIS Measure 
• American Medical Association

¹ Substance Abuse and Mental Health Services Administration’s 2020 National Survey of Drug Use and Health

² NCQA AMM HEDIS® Measure

Reference and review the Blue Cross and Blue Shield of Texas (BCBSTX) Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs), and Texas Health Steps THSteps for Medical Providers, which includes all current vaccine schedules, ImmTrac2 and other important guidance for treating your patients.

Questions or Comments?

Contact us at BHQualityImprovement@bcbstx.com.