Abstract
Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic
adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient
medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic
medication from community mental health centers over a two-year period from community mental health centers. Multivariate
linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users.
Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability
had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline
adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications.
The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional
research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber
communication, quality of care, self-management, and long-term clinical and functional outcomes.
adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient
medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic
medication from community mental health centers over a two-year period from community mental health centers. Multivariate
linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users.
Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability
had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline
adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications.
The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional
research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber
communication, quality of care, self-management, and long-term clinical and functional outcomes.
- Content Type Journal Article
- Category Original Paper
- Pages 1-8
- DOI 10.1007/s10597-012-9528-8
- Authors
- Bradley D. Stein, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
- Jane N. Kogan, UPMC Center for High Value Health Care, U.S. Steel Tower, 9th Fl., 600 Grant Street, Pittsburgh, PA 15219, USA
- Mark J. Mihalyo, Community Care Behavioral Health Organization, One Chatham Center, 112 Washington Place, Suite 700, Pittsburgh, PA 15219, USA
- James Schuster, Community Care Behavioral Health Organization, One Chatham Center, 112 Washington Place, Suite 700, Pittsburgh, PA 15219, USA
- Patricia E. Deegan, 17 Forest Street, Byfield, MA, USA
- Mark J. Sorbero, Community Care Behavioral Health Organization, One Chatham Center, 112 Washington Place, Suite 700, Pittsburgh, PA 15219, USA
- Robert E. Drake, Dartmouth Psychiatric Research Center, Rivermill Commercial Center, 85 Mechanic Street Suite B4-1, Lebanon, NH 03766, USA
- Journal Community Mental Health Journal
- Online ISSN 1573-2789
- Print ISSN 0010-3853