Clinicians of all types who write antipsychotic medications prescriptions for children with Medicaid insurance will soon be receiving surveys to complete on each child.
The Agency of Human Services (AHS), including the Department of Vermont Health Access (DVHA), the Drug Utilization Review (DUR) Board of the DVHA, the Department of Mental Health (DMH) and the Department for Children and Families (DCF) has been interested in the use of antipsychotic medications in children and is sponsoring the survey in an effort to understand more fully the prescribing practices related to antipsychotic use for Vermont youth. The Child and Adolescent Psychiatric Medications Trend Monitoring Group, made up of representatives from different clinical and government backgrounds (including me), has been trying to make recommendations to promote the optimal use of these medications in children and adolescents.
Data from pharmacy insurance claims have been useful but clearly inadequate in answering basic questions about the reasons that lead to antipsychotic medication prescriptions. The thirteen question survey can potentially go a long way towards understanding these decisions on a much more meaningful level. Questions are focused across many areas including the origin of the prescription (such as an inpatient hospitalization), behavioral and diagnostic targets, use of other medications, and employment of nonphrmacological alternatives (such as use and availability of psychotherapy).
A completed survey by mid-December will be mandatory for medications to be approved.
While nobody enjoys more paperwork, the committee is hoping that clinicians will see the potential value in these data as a means towards specific and targeted measures that will improve the probability that the right youth are being prescribed the right medications at the right time.
We recently became aware that the first version of the survey omitted question #7. A new version of the survey is going to be mailed automatically so if you can discard this erroneous copy.
Got a call from a pediatrician with some conerns about limiting treatment options during a time that access to child psychiatrists is very tough. I want to reassure folks that the idea of this survey is not to prevent appropriate use of antipsychotics but to get a better sense of how and when they are entering the treatment plan. Hopefully, there can be more options available before antipsychotic medications are started and/or continued indefinitely.