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A Medicaid Quality Improvement Collaborative on Psychotropic Medication Prescribing for Children

Jonathan Thackeray1, Dushka Crane1, Cynthia Fontanella1

  • 1When this work was done, Dr. Thackeray was with the Ohio Department of Medicaid, Columbus, where Dr. Applegate is affiliated. Dr. Thackeray is now with the Center for Community Health and Advocacy, Dayton Children's Hospital, Dayton, Ohio. Dr. Crane is with the Government Resources Center, Ohio Colleges of Medicine, Columbus. Dr. Fontanella is with the Center for Psychiatry and Behavioral Health, Ohio State University, Columbus. Dr. Sorter is with the Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati. Dr. Baum is with the Division of Developmental Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, Ohio. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column.

Psychiatric Services (Washington, D.C.)
|March 2, 2018
PubMed

Insights

A statewide quality improvement collaborative improved antipsychotic prescribing for children by using data feedback and evidence-based strategies. This initiative addressed key areas like prescribing to young children and polypharmacy.

Area of Science:

  • Child and Adolescent Psychiatry
  • Health Services Research
  • Quality Improvement Science

Background:

  • Antipsychotic prescribing in children requires careful management.
  • Quality improvement initiatives are crucial for optimizing pediatric psychotropic medication use.

Purpose of the Study:

  • To enhance antipsychotic prescribing practices for children within a Medicaid program.
  • To implement and evaluate a statewide quality improvement collaborative.

Main Methods:

  • A multistrategy approach incorporating data-driven feedback.
  • Implementation of evidence-based recommendations for antipsychotic prescribing.
  • Focus on specific prescribing measures in a pediatric population.

Main Results:

  • Improvements observed in prescribing antipsychotics to children under six.
  • Reduction in the prescription of two or more antipsychotics for over two months.
  • Decreased prescription of four or more psychotropic medications.

Conclusions:

  • A statewide quality improvement collaborative can effectively improve pediatric antipsychotic prescribing.
  • Addressing provider engagement and financial sustainability are key challenges for ongoing QI efforts.
  • Multistrategy approaches are effective in optimizing psychotropic medication management in children.

Keywords:
Administration & managementAntipsychoticsMedicaidQuality Improvement

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