Table 1.

Best Practices Framework: Adapted from the American Psychiatric Association Guidelines, 2010

Domain	Indicator	Standard
Identifying depression	Assessment of depression	Routinely assess all patients for depression using standardized measure
Initiating antidepressant treatment	Assessment of need for treatment	Assess need for treatment based on symptom-based threshold (i.e., standard cut-off score on standardized measure or clinical judgment of severity), not based on patient request
	Choice of treatment	Base treatment choice on depression history (e.g., prior treatments) and severity
	Adjustment of starting dose for interaction with ARVs	Adjust antidepressant starting dose to account for interaction with antiretrovirals
Managing treatment	First clinical follow-up after treatment initiation	Within 2 weeks to assess tolerability, within 4 weeks to assess efficacy
	How effectiveness is assessed	Systematic measure of symptoms
	When to increase dose	Increase dose based on formal assessment of tolerability or efficacy
	How high to increase dose	Titrate up to full FDA-approved range until effect is achieved
	When medication is changed	Change medication based on formal assessment of tolerability or efficacy, and only after adequate trial