Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Use
Percentage of patients with depression or bipolar disorder with evidence of an initial assessment that includes an appraisal for alcohol or chemical substance use.
ACP does not support QPP measure 367: "Bipolar Disorder and Major Depression: Appraisal for Alcohol or Chemical Substance Abuse." It is clinically important to screen patients diagnosed with bipolar disorder and major depression for substance abuse; however, measure developers did not provide adequate information to appropriately assess the measure. Additionally, developers cite outdated evidence to form the basis of the measure. It is unclear whether substance use appraisal alone without documentation of an appropriate treatment plan will significantly improve clinical outcomes. Furthermore, the measure specifications do not identify a validated assessment tool. Moreover, it is unclear if the denominator should include patients with pre-existing substance use diagnoses. Finally, CMS does not provide a pre-testing analysis of this measure and electronic data capture may be disproportionately high for some clinicians.