Abstract
This paper describes a program that was established by Florida Medicaid to improve the quality of prescribing of psychotherapeutic
medications. It relates the process used for defining quality medication treatment including the definitions of unusual psychotherapeutic
medication indicators (UPMI). It details the results of analysis of FY 2007–2008 pharmacy claims data using these indicators
that enabled the Program to identify practices and prescribers that required targeted interventions. The most frequently triggered
UPMI for adults involved the use of 2 or more antipsychotics for greater than 60 days; high doses of psychotherapeutic medications
was the indicator most frequently triggered for children closely followed by the use of 2 or more antipsychotics for more
than 45 days. Prescriptions that triggered UPMI were concentrated in a small number of prescribers. These results led to the
Program focusing on these high frequency practices and on the prescribers most associated with them. They also led to the
implementation of new quality improvement initiatives like the implementation of a psychiatric telephone consultation line
for pediatricians who are treating children with serious emotional disturbances who do not have access to child psychiatrists.
medications. It relates the process used for defining quality medication treatment including the definitions of unusual psychotherapeutic
medication indicators (UPMI). It details the results of analysis of FY 2007–2008 pharmacy claims data using these indicators
that enabled the Program to identify practices and prescribers that required targeted interventions. The most frequently triggered
UPMI for adults involved the use of 2 or more antipsychotics for greater than 60 days; high doses of psychotherapeutic medications
was the indicator most frequently triggered for children closely followed by the use of 2 or more antipsychotics for more
than 45 days. Prescriptions that triggered UPMI were concentrated in a small number of prescribers. These results led to the
Program focusing on these high frequency practices and on the prescribers most associated with them. They also led to the
implementation of new quality improvement initiatives like the implementation of a psychiatric telephone consultation line
for pediatricians who are treating children with serious emotional disturbances who do not have access to child psychiatrists.
- Content Type Journal Article
- Category Original Paper
- Pages 1-12
- DOI 10.1007/s10597-012-9497-y
- Authors
- Robert J. Constantine, Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd, MHC 2724, Tampa, FL 33612, USA
- Marie A. McPherson, Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd, MHC 2724, Tampa, FL 33612, USA
- Mary Elizabeth Jones, Medicaid Pharmacy Services, Agency for Health Care Administration, Tallahassee, FL, USA
- Rajiv Tandon, Department of Psychiatry, University of Florida, Gainesville, FL, USA
- Edmund R. Becker, Department of Health Policy and Management, Emory University, Druid Hills, GA, USA
- Journal Community Mental Health Journal
- Online ISSN 1573-2789
- Print ISSN 0010-3853