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Trends and Intervention Results for Unusual Antipsychotic Polypharmacy Prescribing Patterns for Florida Adult and Child Medicaid Population: 2007-2013
The Journal of Health Care Finance
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| Title |
Trends and Intervention Results for Unusual Antipsychotic Polypharmacy Prescribing Patterns for Florida Adult and Child Medicaid Population: 2007-2013
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| Creator |
Lee, Ph.D., Beom S.; Florida Medicaid Drug Therapy Management Program for Behavioral Health, College of Behavioral & Community Services, University of South Florida
McPherson, M.B.A., Marie A.; Florida Medicaid Drug Therapy Management Program for Behavioral Health, College of Behavioral & Community Services, University of South Florida Tandon, M.D., Rajiv; College of Medicine, University of Florida Singh, M.P.H., Sabrina; Florida Medicaid Drug Therapy Management Program for Behavioral Health, College of Behavioral & Community Services, University of South Florida Jones, R.Ph., Mary Elizabeth; Bureau of Pharmacy Services, Florida Agency for Health Care Administration Becker, Ph.D., Edmund R.; Rollins School of Public Health at Emory University |
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| Description |
Background: The rapid growth in the use of antipsychotic medications has created challenges for Medicaid programs in many states. One area of particular concern has been and continues to be unusual antipsychotic polypharmacy prescribing patterns (UAPPPs) for adults and children. Our project has monitored 24 quarters of antipsychotic prescribing patterns for adults and children written by all Florida Medicaid prescribers over the July 2007 through June 2013 period and intervened with selected prescribers with UAPPPs patterns against a set of psychotherapeutic medication guidelines developed and updated in a series of meetings with national experts. This study reports our 6-year findings.Methods: The Medicaid Drug Therapy Management Program for Behavioral Health (MDTMP) at the University of South Florida analyzed the Florida Medicaid prescription patterns for adult and child patients using three measures of UAPPP developed by our expert consensus panels: (1) two antipsychotics for 90 or more days (2AP90), (2) three antipsychotics for 60 days (3AP60), and (3) three antipsychotics for 90 days (3AP90). We report the trends for any prescriber for adult and child Medicaid patients that incurred a UAPPP as well as the results of 250 prescribers that received an intervention.Results: In FY 2012/13, the number of unique adult-patient prescribers hitting one or more UAPPPs had risen to 10,822 prescribers; a 27.3% increase from six years earlier. For children, over the same period, Florida Medicaid prescribers that wrote at least one UAPPP script grew 4.8% to 3,025 prescribers. Overall, for prescribers that wrote one or more UAPPP scripts for both adult and child Medicaid patients, over the 6-year period, the number of scripts per patient and the number of scripts per provider declined ranging from -4.2% to -15.1%. While the group of adult-patient prescribers that wrote one or more UAPPPs showed mixed results on the three UAPPP measures, the group of child-patient prescribers that wrote one or more UAPPPs showed substantial declines in their numbers of patients, numbers of scripts, and number of scripts per prescriber ranging from -22.4% to -100% for each of these three measures. The 250 prescribers, who were among the highest adult- and child-patient prescribers, and experienced an intervention by MDTMP representatives, showed even greater declines in their UAPPP practice patterns and measures. Conclusions: We found that over the six-year study period there were substantial declines in most UAPPP measures of child patients for any prescribers that had one or more UAPPPs and the declining trend was even more substantial when the prescribers were targeted for an intervention by the MDTMP program. For adult patients, the MDTMP interventions for prescribers that incurred an UAPPP also appeared successful for many measures, but for those prescribers that did not experience an intervention the results were mixed.
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| Publisher |
Worldwebtalk.com, Inc.
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| Contributor |
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| Date |
2016-05-15
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| Type |
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion Peer-reviewed Article |
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| Format |
application/pdf
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| Identifier |
http://healthfinancejournal.com/index.php/johcf/article/view/63
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| Source |
Journal of Health Care Finance; Vol 42, No 4, Spring 2016
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| Language |
eng
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| Relation |
http://healthfinancejournal.com/index.php/johcf/article/view/63/65
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| Rights |
Copyright (c) 2016 Journal of Health Care Finance
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