Full Clinical Guidelines - Community First Health Plans.

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9.1 Diabetes Guidelines MANAGEMENT OF DIABETES MELLITUS IN ADULTS AND CHILDREN CFHP has adopted the Minimum Standards for Diabetic Care that were developed by the Texas Diabetes Council, as the standard physician protocol for the preventive care of members who have been diagnosed with diabetes mellitus. The Texas Diabetes Council was created in 1983 by the 68th legislature as the recommendation of the Special Committee on Diabetes Services in Texas. The Council’s mission is to assist in the planning and coordination of diabetes control activities and to develop and carry out a state plan for diabetes control. Diabetes can cause blindness, kidney failure, amputations, heart disease, birth defects, strokes, and premature death and disability. Early interventions can prevent many of the complications associated with diabetes. The Texas Diabetes Council reports: • Prevalence of Diagnosed 1 Diabetes in Persons 18 and Older • An estimated 1.7 million persons aged eighteen years and older in Texas (9.7% of this age group) have been diagnosed with diabetes. Nationwide, 19.8 million persons eighteen years of age and older have been diagnosed with diabetes (8.3% of this age group). • Prevalence of Undiagnosed 2 Diabetes in Persons 18 and Older • Another estimated 425,157 persons aged eighteen years and older in Texas are believed to have undiagnosed diabetes (based on 2003-2006 NHANES age-adjusted prevalence estimate of 2.5% of persons twenty years of age and older). The total for both diagnosed and undiagnosed diabetes is 2.1 million. • Diabetes Mortality 3 Rate (Per 100,000) by Race/Ethnicity, Texas, 2006 • The 2006 diabetes mortality rate for Texas was 27 deaths per 100,000 persons. Mortality rates for each race/ ethnicity were applied to the 2006 population by race/ethnicity: • 20 per 100,000 whites (non-Hispanic) • 42 per 100,000 Hispanics • 49 per 100,000 blacks (non-Hispanic) • 21 per 100,000 persons who fall in the “Other” category The 2006 mortality rates (per 100,000) for blacks (non-Hispanic) and Hispanics were more than double that of whites (non-Hispanic). The purpose of the guidelines is to ensure that all adults with diabetes who are enrolled with Community First receive accepted standards of care. These guidelines will promote consistency in clinical practice and improve the quality and outcome of care for our members. Complete history & physical Diabetes Education* Medical Nutrition Therapy Exercise Counseling Psychosocial Counseling Diabetes Minimum Practice Recommendations (Established by the Texas Diabetes Council Revised 7-27-06) Examination/Test Lifestyle / Behavior Changes Counseling Weight / Height / BMI Adult Overweight = BMI 25-29.9 Adult Obesity = BMI ≥30 Blood Pressure Target:
Examination/Test Oral / Dental Inspection Refer for dental care annually or as needed Growth and Development (including height) in Children Aspirin / Antiplatelet Prophylaxis (if no contra-indications) Type 1 or 2 ≥ age 30 A1c Target: A1c≤6.5% Kidney Evaluation Estimate GFR (eGFR) & microalbumin determination (≥30mg = abnormal). Consider nephro/endocrine evaluation at Stage 3 CKD (eGFR
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Page 9 and 10: The purpose of these guidelines is
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Page 13 and 14: Recommended Adult Immunization Sche
Page 15 and 16: Footnotes — Recommended Adult Imm
Page 17 and 18: CFHP has adopted the National Asthm
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Page 33 and 34: Criteria Requirements 33. Release o
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Page 45 and 46: GLYCEMIC CONTROL BIBLIOGRAPHY • R
Page 47 and 48: Publication # 45-11647 Targets* A1
Page 49 and 50: WORKSHEET Revised 10-20-05 Advancin
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Page 53 and 54: Publication # 45-11266 Age 126 mg/d
Page 55 and 56: Hypertension Algorithm for Diabetes
Page 57 and 58: Lipid Algorithm For Type 1 and Type
Page 59 and 60: References: Revised 1-24-08 • Col
Page 61 and 62: WEIGHT LOSS ALGORITHM FOR OVERWEIGH
Page 63 and 64: Publication #45-11825 Screening 1 :
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Page 67 and 68: DIABETIC FOOT CARE/REFERRAL ALGORIT
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Page 73 and 74: Revised 10-25-07 IV INSULIN INFUSIO
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Page 77 and 78: Revised 2-21-08 Publication #: E45-
Page 79 and 80: Abbreviations AGI Alpha-Glucosidase
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Identification, Evaluation, and Tre
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11.3 Treatment of Hypertension H EA
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ALGORITHM FOR TREATMENT OF MAJOR DE
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CFHP has established guidelines for
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A. Documentation ______ B. Continui
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CFHP PCP MEDICAL RECORD REVIEW TOOL
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13.3 Specialist Medical Record Docu
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13.4 Specialist Medical Record Revi
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Risk Factors for Osteoporosis Fract
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It is well documented that obesity
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CLASSIFICATION OF OVERWEIGHT AND OB
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16.1.1 Preventive Pediatric Health
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H EALTH PLANS www.cfhp.com 117
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TEXAS MEDICAID PROVIDER PROCEDURES
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CHILDREN’S SERVICES HANDBOOK P h
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CHILDREN’S SERVICES HANDBOOK P R
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H EALTH PLANS www.cfhp.com 139
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FIGURE 2: Recommended immunization
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Comprehensive antepartum care is vi
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The following variables should be e
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CRITERIA 19. Unresolved Problems Fr
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CFHP OB/GYN SPECIALTY MEDICAL RECOR
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CFHP OB/GYN SPECIALTY MEDICAL RECOR
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According to the National Institute
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. aminotransferase (AST) and alanin
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PREVENTION RECOMMENDATIONS 1. The E
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2 to 20 years: Boys Body mass index
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AsthmaMatters is an initiative deve
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According to the Centers for Diseas
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