2022 Clinical Practice Guidelines

Clinical practice guidelines are documents which seeks to guide decisions about the diagnosis and treatment of certain health conditions. Clinical practice guidelines are based on scientific evidence, review of the medical literature, or appropriately established authority. All recommendations are based on published agreed on guidelines and do not favor any treatment based solely on cost considerations.

The recommendations for care are suggested as guides for making clinical decisions. Clinicians and their patients must work together to develop individual treatment plans that are tailored to the specific needs and circumstances of each patient.

Senior Whole Health of Massachusetts (SWH of MA) reviews and revises guidelines as clinical evidence is updated. Once the guidelines have been reviewed and modified as needed by a dedicated Quality Improvement Committee, SWH of MA providers will be notified of any changes and updates by fax and/or mail.

To request a copy of any guideline, please contact SWH of MA Provider Services.

 

2022 Clinical Practice Guidelines

The guidelines below were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee. Committee approval dates are shown for 2015 and beyond. All guidelines are reviewed monthly by the National Quality Improvement Committee and are approved annually unless otherwise noted.

Clinical guidelines are not used by Senior Whole Health of Massachusetts (SWH of MA) to decide benefit coverage. The guidelines are an educational tool to aid clinical decision-making. They are not a standard of care. The physician should adapt the guideline when clinical judgment so indicates.


Acute Stress and Post-Traumatic Stress Disorder (PTSD)


Senior Whole Health has adopted the guideline for Acute Stress and Post-Traumatic Stress Disorder from the Department of Veterans Affairs & Department of Defense.

The Clinical Practice Guideline may be accessed here.

Published: June 2017

Revised: N/A

SWH of MA adopted/reviewed: April 2022


Anxiety/Panic Disorder


Senior Whole Health has adopted the guideline for Anxiety/Panic Disorder from the American Psychiatric Association.

The Clinical Practice Guideline may be accessed here.

Published: January 2009

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Asthma


Senior Whole Health has adopted the guideline for Diagnosis and Management of Asthma (EPR-3) from the National Institute of Health (NIH): National Heart, Lung, and Blood Institute (NHLBI).

The Clinical Practice Guideline may be accessed here.

Published: July 2007

Revised: December 2020

SWH of MA adopted/reviewed: April 2022

 

Attention Deficit Hyperactivity Disorder (ADHD)


Senior Whole Health has adopted the guideline for Diagnosis, Evaluation, and Treatment of Attention-Deficit Hyperactivity Disorder in Children and Adolescents from the Journal of the American Academy of Pediatrics (AAP).

The Clinical Practice Guideline may be accessed here.

Published: November 2011

Revised: October 2019

SWH of MA adopted/reviewed: April 2022

 

Autism


Senior Whole Health has adopted the guideline for Identification, Evaluation, and Management of Children With Autism Spectrum Disorder from the The American Academy of Pediatrics.

The Clinical Practice Guideline may be accessed here.

Published: January 2020

Revised: N/A

SWH of MA adopted/reviewed: April 2022


Bipolar Disorder


Senior Whole Health has adopted the guideline for Bipolar Disorder from the American Psychiatric Association.

The Clinical Practice Guideline may be accessed here.

Published: April 2002

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Children with Special Health Care Needs


Senior Whole Health has adopted the guideline for Promoting Health for Children and Youth with Special Health Care Needs from Bright Futures.

The Clinical Practice Guideline may be accessed here.

Published: 2017

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Chronic Kidney Disease


Senior Whole Health has adopted the guideline for Evaluation and Management of Chronic Kidney Disease Guideline from the National Kidney Foundation, Kidney Disease Outcome Quality Initiative (NKF KDOQI).

The Clinical Practice Guideline may be accessed here.

Published: March 2014

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Chronic Obstructive Pulmonary Disease


Senior Whole Health has adopted the guideline for Global Strategy for Diagnosis, Management, and Prevention of COPD from the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The Clinical Practice Guideline may be accessed here.

Published: 2011

Revised: November 2021

SWH of MA adopted/reviewed: January 2022, April 2022

 

Dementia


Senior Whole Health has adopted the guideline for Dementia from the National Institute for Health and Care Excellence.

The Clinical Practice Guideline may be accessed here.

Published:June 2018

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Depression


Senior Whole Health has adopted the guideline for Depression from the American Psychological Association.

The Clinical Practice Guideline may be accessed here.

Published:February 2019

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Depression


Senior Whole Health has adopted the guideline for Treatment of Patients with Major Depressive Disorder from the American Psychiatric Association (APA).

The Clinical Practice Guideline may be accessed here.

Published: October 2010

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Diabetes


Senior Whole Health has adopted the guideline for Diabetes from the American Diabetes Association (ADA).

The Clinical Practice Guideline may be accessed here.

Published: January 2015

Revised: December 2021

SWH of MA adopted/reviewed: February 2022, April 2022

 

Heart Failure in Adults


Senior Whole Health has adopted the guideline for Management of Heart Failure from the American College of Cardiology (ACA).

The Clinical Practice Guideline may be accessed here.

You may also visit the web site below for more information. 

American College of Cardiology: here.

Published: 2013

Revised: May 2022

SWH of MA adopted/reviewed: April 2022, July 2022

 

Homelessness - Special Health Care Needs


Senior Whole Health has adopted the guideline for Adapting Your General Recommendations for the Care of Homeless Patients from the National Health Care for the Homeless Council. 

The Clinical Practice Guideline may be accessed here.

Published: 2010

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Hypertension


Senior Whole Health has adopted the guideline for Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults from the American College of Cardiology.

The Clinical Practice Guideline may be accessed here.

Published: February 2014

Revised: August  2018

SWH of MA adopted/reviewed: April 2022

 

Obesity


Senior Whole Health has adopted the guideline for Comprehensive Medical Care of Patients with Obesity from the American Association of Clinical Endocrinologists (AACE).

The Clinical Practice Guideline may be accessed here.

Published: July 2016

Revised: N/A

SWH of MA adopted/reviewed: April 2022

Opioid Management


Senior Whole Health has adopted the guideline for Use of Medications in the Treatment of Addiction Involving Opioids from the American Society of Addiction Medicine (ASAM).

The Clinical Practice Guideline may be accessed here.

Published: June 2015

Revised: January 2020

SWH of MA adopted/reviewed: April 2022

Senior Whole Health has adopted the guideline CDC Guideline for Prescribing Opioids for Chronic Pain.

The Clinical Practice Guideline may be accessed here.

Published: March 2016

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Opioid Management-Treatment of Opioid Use Disorder


Senior Whole Health has adopted the guideline for Opioid Management from the American Society of Addiction Medicine.

The Clinical Practice Guideline may be accessed here.

Published: December 2019

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Perinatal Care


Senior Whole Health has adopted the guideline for Perinatal Care from the American College of Obstetricians and Gynecologists.

The Clinical Practice Guideline may be accessed here - Guidelines can be reviewed by ACOG members only using a secure password.

Published: July 2012

Revised: September 2017

SWH of MA adopted/reviewed: April 2022

 

Pregnancy Management


Senior Whole Health has adopted the guideline for Routine Prenatal and Postnatal Care from Michigan Quality Improvement Consortium.

The Clinical Practice Guideline may be accessed here.

Published: 2018

Revised: June 2020

SWH of MA adopted/reviewed: April 2022

 

Schizophrenia


Senior Whole Health has adopted the guideline for Schizophrenia from the American Psychiatric Association,

The Clinical Practice Guideline may be accessed here.

Published: 2021

Revised: N/A

SWH of MA adopted/reviewed: April 2022



Sickle Cell Disease


Senior Whole Health has adopted the guideline for Management of Sickle Cell Disease from the National Heart, Lung, and Blood Institute (NHLBI).

The Clinical Practice Guideline may be accessed here.

Published: December 2014

Revised: N/A

SWH of MA adopted/reviewed: April 2022



Substance Abuse Treatment


Senior Whole Health has adopted the guideline for Detoxification and Substance Abuse Treatment from the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Clinical Practice Guideline may be accessed here.

Published: October 2015

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Suicide Risk


Senior Whole Health has adopted the guideline for Assessment and Management of Patients at Risk for Suicide from the Department of Veterans Affairs & Department of Defense.

The Clinical Practice Guideline may be accessed here.

Published: May 2019

Revised: N/A

SWH of MA adopted/reviewed: April 2022

 

Trauma-Informed Primary Care


Senior Whole Health has adopted the guideline for Fostering Resilience and Recovery: A Change Package for Advancing Trauma-Informed Primary Care from The National Council for Mental Wellbeing.

The Clinical Practice Guideline may be accessed here.

Published: November 2019

Revised: N/A

SWH of MA adopted/reviewed: April 2022