Clinical practice guidelines

Use these resources to find information about specific treatment types and guidelines

Asthma

 

National Heart, Lung and Blood Institute (NHLBI)-Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full report 2007

Congestive Heart Failure (CHF)

 

American Heart Association task force on practice guidelines

Coronary Artery Disease (CAD)

 

Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

Chronic Obstructive Pulmonary Disease (COPD)

 

Global Initiative for Chronic Obstructive Lung Disease

Chronic Pain Opioid Prescribing Guidelines

 

CDC Guideline for Prescribing Opioids for Chronic Pain

Diabetes

 

American Diabetes Association (ADA) Standards of Medical Care in Diabetes- 2016

Adult Preventive Care

 

Centers for Disease Control and Prevention Adult Immunization Schedule (over 18 years old)

American Cancer Society Guidelines for the Early Detection of Cancer

  • Breast cancer
  • Colorectal cancer and polyps
  • Cervical cancer
  • Endometrial (uterine) cancer
  • Prostate cancer

Tobacco Cessation

 

Counselling patients to quit

Behavioral Health (mental health and substance abuse) screening, assessment, and treatment, including medication management and PCP follow-up

 

- Depression

 

American Psychiatric Association (APA) Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition

 

- Psychosis and Schizophrenia in Adults

 

Psychosis and schizophrenia in adults: treatment and management

 

Clozapine Shared System Risk Evaluation and Mitigation Strategies (REMS) Program

 

- Substance Abuse

 

Screening, Brief Intervention and Referral to Treatment (SBIRT)

 

SAMHSA Screening, Brief Intervention and Referral to Treatment (SBIRT)

 

Ohio MHAS Screening, Brief Intervention and Referral to Treatment (SBIRT)

 

-Alcohol Abuse

 

National Institute on Alcohol Abuse and Alcoholism (NIAAA), Helping Patients Who Drink Too Much, A Clinician’s Guide, 2005 Edition

 

-Opioid Use Disorder

 

National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use

Clinical pharmacy medication review

 

Medication management guideline

Dental services

 

Oral hygiene care for functionally dependent and cognitively impaired older adults

ADA Center for evidence‐based dentistry

Community reintegration and support

 

The effect of guided care teams on the use of health services

Long‐term Care (LTC) residential coordination of services

 

Transitions of care in the long-term care continuum

Medical necessity criteria

 

  • Criteria required by applicable state or federal regulatory agency
  • Milliman Care Guidelines as the primary decision support for most medical diagnoses and conditions
  • Aetna Clinical Policy Bulletins (CPBs)
  • LOCUS/CALOCUS Guidelines
  • American Society of Addiction Medicine (ASAM) Criteria