An Evaluation of a Multidisciplinary Pediatric Behavioral Health Medication Initiative Workgroup’s Interventions on Medication Prescribing in a Population of Medicaid Patients

Chiara, Ashley N.; Kashalikar, Neha; Pomfret, Thomas C.; Lenz, Kimberly J.; Faber, Donna M.; Goldstein, Joel; Clements, Karen M.; Angelini, Michael C.; Leto, Patricia; Jeffrey, Paul L.

doi:10.18553/jmcp.2018.24.8.746

Cited by 3 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CMM focuses on optimizing the patient’s entire drug therapy whereas disease management is centered on one disease state, such as diabetes, heart failure, asthma, and hypertension. In the case of CPAs involving children, CMM could be initiated in patients with two or more active chronic diagnoses that are managed with medications [75,76], for immunizations [77], during transitions of care from hospital to home [12,78], or when children with neurodevelopmental issues become adolescents [79,80,81,82].…”

Section: Collaborative Practice and Agreements (Cpa)mentioning

confidence: 99%

“…Primary care outcomes in a telehealth-based chronic disease management program that includes clinical pharmacists for diabetes, hyperlipidemia, hypertension control and tobacco cessation can be achieved in targeted patients [94]. Multidisciplinary therapeutic class management in pediatric behavioral health completed peer-to-peer consultations via telepharmacy for medication changes, dose reductions, and elimination of polypharmacy within or across behavioral health medication classes [79].…”

Section: Network Design Requirements and Electronic Health Record mentioning

confidence: 99%

See 1 more Smart Citation

Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective

et al. 2019

View full text Add to dashboard Cite

Children with special health care needs (CSHCN) use relatively high quantities of healthcare resources and have overall higher morbidity than the general pediatric population. Embedding clinical pharmacists into the Patient-Centered Medical Home (PCMH) to provide comprehensive medication management (CMM) through collaborative practice agreements (CPAs) for children, especially for CSHCN, can improve outcomes, enhance the experience of care for families, and reduce the cost of care. Potential network infrastructures for collaborative practice focused on CSHCN populations, common language and terminology for CMM, and clinical pharmacist workforce estimates are provided. Applying the results from the CMM in Primary Care grant, this paper outlines the following: (1) setting up collaborative practices for CMM between clinical pharmacists and pediatricians (primary care pediatricians and sub-specialties, such as pediatric clinical pharmacology); (2) proposing various models, organizational structures, design requirements, and shared electronic health record (EHR) needs; and (3) outlining consistent documentation of CMM by clinical pharmacists in CSHCN populations.

show abstract

Section: Collaborative Practice and Agreements (Cpa)mentioning

confidence: 99%

Section: Network Design Requirements and Electronic Health Record mentioning

confidence: 99%

Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective

et al. 2019

View full text Add to dashboard Cite

show abstract

Development of a Symptom-Focused Model to Guide the Prescribing of Antipsychotics in Children and Adolescents: Results of the First Phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial

Penfold

Thompson

Hilt

et al. 2022

Journal of the American Academy of Child & Adolescent Psych

View full text Add to dashboard Cite

Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial

Penfold,

Idu,

Coley

et al. 2024

Child Psychology Psychiatry

View full text Add to dashboard Cite

BackgroundAntipsychotic medications (AP) are inappropriately prescribed to young people. The goal of this pragmatic trial was to test a four‐component approach to improved targeting of antipsychotic prescribing to people aged ≥3 and <18 years.MethodsClinicians in four health systems were cluster randomized by the number of previous AP orders and service line – specialty mental health and all others. Intervention arm clinicians received a best practice alert and child psychiatrist consultation and feedback. Families received system navigation and expedited access to psychotherapy. Primary outcomes were total days' supply of AP medication and proportion of youth with any AP supply at 6 months. We estimated the log‐odds of AP use at 6 months and the relative rate of AP over 6 months. The Safer and Targeted Use of Antipsychotics in Youth (SUAY) trial took place between 3/2018 and 12/2020.ResultsThe trial enrolled 733 patients. The odds ratio (OR) comparing use at 6 months was 0.75 (95% CI: 0.52, 1.09). The mean number of days using AP was 118.5 for intervention patients and 128.2 for control patients (relative risk [RR] = 0.92; 95% CI: 0.81–1.04). Exploratory heterogeneity of treatment effects (HTE) was not detected in groups defined by age, gender, provider specialty, and insurance type. HTE by race/ethnicity was present: among youth of color, mean days' supply was 103.2 for intervention arm and 131.2 for the control arm (RR 0.79, 95% CI: 0.67–0.93). Among secondary outcomes, only new psychotherapy referrals differed with 44.3% (n = 154) of intervention participants having a new order for psychotherapy compared to 33.5% (n = 129) in the control arm (OR 1.47: 95% CI: 1.01–2.14).ConclusionsThis intervention did not result in less AP use at 6 months or a reduction in the days' supply of AP medication, although psychotherapy orders increased. The intervention may be effective for some subgroups.

show abstract

An Evaluation of a Multidisciplinary Pediatric Behavioral Health Medication Initiative Workgroup’s Interventions on Medication Prescribing in a Population of Medicaid Patients

Abstract: No outside funding supported this study. The authors have nothing to disclose. A poster of this project was presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2017; March 27-30, 2017; in Denver, CO.

Cited by 3 publications

References 11 publications

Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective

Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective

Development of a Symptom-Focused Model to Guide the Prescribing of Antipsychotics in Children and Adolescents: Results of the First Phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial

Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial

Contact Info

Product

Resources

About