Used correctly, psychotropic drugs help people with behavioral health conditions function more effectively with their families, friends, and work colleagues. Incorrect use too often increases costs without improving the health outcomes of patients. 32.9% of patients prescribed behavioral health medications have a regime that is identified as having an opportunity for management improvement.1
Uneven Care Leads to Uneven Results
The lack of coordinated care between primary care physicians and specialists frequently results in unintended cases of poly-pharmacy. Most psychotropic medications are prescribed by primary care physicians and pediatricians who typically have limited expertise in how to best manage these drugs. The side effects of antipsychotics and antidepressants often lead to members not taking their medication as prescribed, resulting in decreased benefits of the drugs. Meanwhile, “off-label” prescribing is increasing for children, with few evidence- based guidelines and no consensus on appropriate use.
A Model for Standardized Care
Understanding the importance of effective and appropriate psychotropic drug prescribing, Beacon has developed evidence-based algorithms to identify medication-related problems. Due to its expertise in psychopharmacology management, Beacon’s Psychotropic Drug Intervention Program (PDIP) picks up where traditional Pharmacy Benefit Management services stop by:
- Identifying cases of clinically ineffective dosing and doses with safety concerns
- Monitoring timely prescription refills for members taking psychotropic drugs to ensure adherence to prescribed treatment regimens
- Identifying instances of non-clinically appropriate poly-pharmacy
- Recognizing potential cases of uncoordinated care and prescribing by multiple clinicians treating the same member
- Checking for possible fraudulent or abusive prescribing and utilization patterns
Better Results for Members and Caregivers
PDIP improves medication safety and achieves positive behavior change for both members and providers. For providers, PDIP interventions produce positive, measurable results for sub-optimal dosing and poly-pharmacy prescribing. For members, PDIP improves medication adherence.
Improved Medication Adherence Lowers Readmission Rates
These interventions ultimately lead to positive behavior change for both members and providers. For providers, PDIP interventions produce positive, measurable, control group compared results for sub-optimal dosing and poly-pharmacy prescribing. For members, PDIP improves medication adherence, which as noted above, reduces costs through lower readmission rates. In the end, member health outcomes improve – cost effectively.
Behavior Change after PDIP Implementation
1 PDIP internal data 2012