1 / 17

Mental Health Quality Advisory Committee April 18, 2013

Mental Health Quality Advisory Committee April 18, 2013. Retro-DUR Intervention Outcomes Assessments for: Duplicate Sedatives & Hypnotics Atypical Antipsychotic Utilization in Children & Adolescents Indiana Family and Social Services Administration. Outcomes Assessment:.

tayten
Download Presentation

Mental Health Quality Advisory Committee April 18, 2013

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Mental Health Quality Advisory Committee April 18, 2013 Retro-DUR Intervention Outcomes Assessments for: Duplicate Sedatives & Hypnotics Atypical Antipsychotic Utilization in Children & Adolescents Indiana Family and Social Services Administration

  2. Outcomes Assessment: Duplicate Sedatives & Hypnotics

  3. Background • The majority of anti-anxiety and sedative/hypnotic medications are similar in terms of their pharmacology and mechanism of action. • Barbiturates, benzodiazepines (BZD), or non-benzodiazepines produce their clinical effects by interacting with the GABA/Chloride receptor complex. • Use of multiple anti-anxiety and sedative/hypnotic medications concurrently increases the risk of additive effects at the receptor complex and may result in over sedation or other adverse effects. • Whenever possible, therapy with these agents should be simplified to use of a single agent. • The Office of Medicaid Policy & Planning (OMPP) implemented the Duplicate Sedative Hypnotic & BZD Smart PA rule in 2010 and followed with this retro-DUR intervention to emphasize importance of single agent therapy.

  4. Intervention • Purpose: • The intervention was intended to address the safety concerns associated with the duplicate use of sedative hypnotic and BZD medications. • Intervention Type • Population-based mailing • Mailing date: January 2012 • Total of 1646 letters mailed to physicians • Total of 2602 letters sent to adjusted target patients* *Adjusted Target Patients – All patients of physicians who were included in the intervention had pharmacy claims and were active plan members throughout the post-intervention time period. When outcomes were assessed, these patients’ pre-intervention (baseline) hits were re-evaluated to make certain that the status of clinical indicators had not changed due to late pharmacy and medical claims.

  5. Methodology • Pharmacy drug claims from July 2011 through December 2011 were reviewed for the following: • Changes in intervention-related pharmacy dollars paid • Pharmacy dollars paid per patient per month (PPPM) • Number of pharmacy claims • The intervention consisted of education outreach to physicians whose patients were targeted • Physicians with at least one patient that met the criteria below were mailed an intervention letter: • Duplicate Anti-Anxiety Medication Therapy • Duplicate Sedative/Hypnotic Medication Therapy • Duplicate Anti-Anxiety and Sedative/Hypnotic Medication Therapy

  6. Results • Changes in Clinical Indicators:

  7. Results • Savings:

  8. Conclusions • The intervention focused on improving prescribing practice and reducing the risk due to duplication. • The intervention was successful in reducing the total number of duplicate therapies for sedative hypnotics and BZDs within targeted patients by 55.1%. • The intervention decreased the amount paid for targeted drugs by $5.55 as measured in the post-intervention period. • The intervention yielded an estimated savings of nearly $87,000 in targeted drug expenditures as measured in the six-month post-intervention period.

  9. Outcomes Assessment: Atypical Antipsychotic Utilization in Children & Adolescents

  10. Background • The use of psychotropic medications in children and adolescents have become increasingly more common in recent years. • Indiana participated in the AHRQ-Rutgers study on antipsychotic use in children and adolescents in Indiana Medicaid. • OMPP conducted this retro-DUR to emphasize the importance of limiting antipsychotic prescribing in children and adolescents.

  11. Intervention • Purpose: • To encourage physicians to evaluate atypical antipsychotic medication use in children and adolescents. • The goal was to reduce the risks and adverse outcomes associated with antipsychotic use. • Intervention Type • Population-based mailing • Mailing date: June 2012 • Total of 1638 letters mailed to physicians • Total of 2675 letters sent to adjusted target patients* *Adjusted Target Patients – All patients of physicians who were included in the intervention had pharmacy claims and were active plan members throughout the post-intervention time period. When outcomes were assessed, these patients’ pre-intervention (baseline) hits were re-evaluated to make certain that the status of clinical indicators had not changed due to late pharmacy and medical claims.

  12. Methodology • Pharmacy drug claims from December 2011 through May 2012 were reviewed for the following: • Changes in intervention-related pharmacy dollars paid • Pharmacy dollars paid PPPM • Number of pharmacy claims • The intervention consisted of education outreach to physicians whose patients were targeted • Physicians with at least one patient that met the criteria below were mailed an intervention letter: • Atypical Antipsychotic in Children • Higher than Recommended Dosage of Atypical Antipsychotic in Children and Adolescents

  13. Results • Changes in Clinical Indicator (Age):

  14. Results • Savings:

  15. Conclusions • The intervention focused on improving prescribing practice and reducing the risks associated with antipsychotic therapy. • The intervention was successful in reducing atypical antipsychotic therapy within targeted patients by 43.2%. • The intervention decreased the amount paid for targeted drugs by $91.83 as measured in the post-intervention period. • The intervention yielded an estimated savings of nearly $1.5 million in targeted drug expenditures as measured in the six-month post-intervention period.

  16. Questions???

More Related