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Program for the use of antipsychotics with metabolic monitoring in North Carolina medicaid children

Published online by Cambridge University Press:  23 March 2020

S. Wegner ,
J. McKee ,
T. Trygstad ,
L. Wegner  and
A. Stiles
S. Wegner
Affiliation:
AccessCare, Morrisville, USA University of North Carolina-Chapel Hill, department of pediatrics, Chapel Hill, USA
J. McKee
Affiliation:
Community care of North Carolina, pharmacy operations and payer programs, Raleigh, USA
T. Trygstad
Affiliation:
Community care of North Carolina, pharmacy programs, Raleigh, USA
L. Wegner
Affiliation:
University of North Carolina-Chapel Hill, UNC development and behavioral pediatrics, Chapel Hill, USA
A. Stiles
Affiliation:
University of North Carolina-Chapel Hill, Sr. VP - network development and strategic affiliations, Chapel Hill, USA

Abstract

Introduction

Children are at greater risk than adults for weight gain and metabolic disorders including hyperlipidemia and diabetes with newer antipsychotics. A web-based safety-monitoring program using a prior documentation model required submission of patient safety data (prior documentation) for insurance coverage at the pharmacy point of sale. This program launched in April of 2011, covering all NC Medicaid and Health Choice recipients under age 18. Clinical monitoring parameters and interactive educational features were developed with pediatric psychiatric experts and key mental health stakeholder groups.

Objectives

Using a four-year run in period and a full 9 months of post implementation claims data, evaluate the rates of antipsychotic prescribing and safety monitoring before and after the implementation of the A + KIDS program.

Results

Implementation of this program was associated with a consistent monthly decrease in overall antipsychotic use and increases in patient monitoring of glucose and lipid (Figure. 1, Table 1).

Conclusions

The prior documentation registry was effective in decreasing antipsychotic use and increasing safety monitoring. The impact of changing to more traditional prior authorization on the same clinical endpoints is currently under evaluation.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Mental health care; Mental health policies and migration and mental health of immigrants
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S343
Copyright
Copyright © European Psychiatric Association 2017

Fig. 1 A+KIDS Population Antipsychotic Prescription Fills per 1000 Medicaid Enrollees Per Day

Table 1 Percent of A+KIDS Patients on an Antipsychotic with Metabolic Monitoring Recorded in Claims.

Figure 0

Fig. 1 A+KIDS Population Antipsychotic Prescription Fills per 1000 Medicaid Enrollees Per Day

Figure 1

Table 1 Percent of A+KIDS Patients on an Antipsychotic with Metabolic Monitoring Recorded in Claims.

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