Practice Guidelines

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Quick links: Medical Guidelines | Behavioral Health Guidelines | Oral Health Guidelines

Practice Guideline Adoption and Recommended Use

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PacificSource Community Solutions, PacificSource Medicare, and PacificSource Health Plans support the use of practice guidelines based on nationally recognized, valid, and reliable evidence-based clinical literature or a consensus of professionals in a particular field.

PacificSource adopts medical, behavioral, and oral health guidelines to assist providers and members in making decisions about appropriate healthcare choices. PacificSource practice guidelines are not meant to replace the clinical judgment of a treating provider. Guidelines are reviewed and updated as needed on an annual basis.

In all cases, benefit determinations should be based on the applicable contract coverage. Should there be any discrepancy between these guidelines and the contract language, the contract language will take precedence.

Medical Guidelines

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Asthma

• GINA Report, Global Strategy for Asthma Management and Prevention (Global Initiative for Asthma)
  

Coronary Artery Disease

• ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
  
• Recent Innovations, Modifications, and Evolution of ACC/AHA Clinical Practice Guidelines: An Update for Our Constituencies: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
  
• AACE/ACE Guidelines for Management of Dyslipidemia and Prevention of Cardiovascular Disease
  
• American College of Cardiology (ACC) Guidelines and Clinical Documents
  

COPD

• Gold Reports for COPD Management (Global Initiative for Chronic Obstructive Lung Disease)
  

Diabetes

• Standards of Medical Care in Diabetes (American Diabetes Association)
  
• American Association of Clinical Endocrinologists Practice Guidelines (AACE)
  

Heart Failure

• Guidelines for the Management of Heart Failure (American College of Cardiology, American Heart Association Task Force, and the Heart Failure Society of America on Clinical Practice Guidelines)
  
• American College of Cardiology (ACC) Guidelines and Clinical Documents
  

Immunizations and Preventive Services

• CDC Catch-Up Immunization Schedule Who Start Late or Who Are More Than 1 Month Behind. Recommendations for ages 18 years or younger
  
• CDC Adult Immunization Schedule. Recommendations for ages 19 years or older
  
• CDC Vaccines for Children: Vaccines by Age
  
• U.S. Preventive Services Task Force (USPSTF): Recommendations for primary care and prevention
  

Obesity

• Academy of Nutrition and Dietetics: Interventions for the Treatment of Overweight and Obesity in Adults
  
• American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity
  
• American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society (AHA/ACC/TOS) Guideline for the Management of Overweight and Obesity in Adults
  

Pain

• Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain
  
• Oregon Pain Guidance (OPG) Pain Treatment Guidelines
  

Prenatal Care

• American College of Obstetricians and Gynecologists Clinical Information (ACOG)
  
• Breastfeeding Centers for Disease Control and Prevention (CDC) Guidelines
  

Behavioral Health Guidelines

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Attention-deficit / hyperactivity disorder (ADHD) Children and Adolescents

• Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention Deficit/Hyperactivity disorder in Children and Adolescents, American Academy of Pediatrics
  

Attention-deficit / hyperactivity disorder (ADHD) Adults

• Attention deficit hyperactivity disorder: diagnosis and management, NICE guideline [NG87], National Institute for Health and Care Excellence
  

Anxiety

• Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults, American Family Physician
  

Autism Spectrum Disorder

• Behavior Analyst Certification Board Applied Behavior Analysis Treatment of Autism Spectrum Disorder: Practice Guideline for Healthcare Funders and Managers, Second Edition
  

Depression

• American Psychiatric Association (APA) Practice Guideline for the Treatment Of Patients With Major Depressive Disorder
  
• Journal of Clinical Psychiatry Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression
  

Eating Disorders

• APA Practice Guideline for the Treatment of Patients with Eating Disorders
  

Gender Affirming Care

• Standards of Care for the Health of Transgender and Gender Diverse People, The World Professional Association for Transgender Health
  

Bipolar Disorder

• Bipolar disorder: assessment and management, Clinical guideline [CG185], National Institute for Health and Care Excellence
  

Psychotic Disorders

• Practice Guideline for the Treatment of Patients with Schizophrenia, American Psychiatric Association
  
• Practice Guidelines for Oregon Early Assessment and Support Alliance
  
• Strategies to Promote Best Practice in Antipsychotic Prescribing for Children and Adolescents, SAMHSA
  

Trauma Informed Care

• Trauma Specific Services: A resource for implementation and use, Trauma Informed Oregon
  

Substance Use Disorders

• The American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-Related Disorders
  
• National Institute on Drug Abuse Principles of Drug Treatment: A Research- Based Guide
  
• SAMHSA TIP (Treatment Improvement Protocols) 63: Medications for Opioid Use Disorder For Healthcare and Addiction Professionals, Policymakers, Patients, and Family: Executive Summary
  
• SAMHSA TIP (Treatment Improvement Protocols) 63: Medications for Opioid Use Disorder For Healthcare and Addiction Professionals, Policymakers, Patients, and Family: Full Document
  
• SAMHSA Medication for the Treatment of Alcohol Use Disorder: A Brief Guide
  

Oral Health Guidelines

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• Oral Health Policies & Recommendations (The Reference Manual of Pediatric Dentistry), The American Academy of Pediatric Dentistry
  
• Clinical Practice Guidelines and Dental Evidence, The American Dental Association (ADA) Center for Evidence-Based Dentistry
  
• U.S. Preventative Services Task Force (USPSTF) Recommendation Statement: Prevention of Dental Caries in Children Younger than 5 Years: Screening and Interventions