Research Data from University of Pennsylvania Update Understanding of Health Services (Incorporating clinician insight and care plans into an audit and feedback initiative for antipsychotic prescribing to Medicaid-enrolled youth in Philadelphia): Health and Medicine – Health Services

2024 MAY 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on health services have been published. According to news reporting from the University of Pennsylvania by NewsRx journalists, research stated, “Audit and feedback (A/F), which include initiatives like report cards, have an inconsistent impact on clinicians’ prescribing behavior. This may be attributable to their focus on aggregate prescribing measures, a one-size-fits-all approach, and the fact that A/F initiatives rarely engage with the clinicians they target.”

Funders for this research include Community Behavioral Health, United States.

Our news reporters obtained a quote from the research from University of Pennsylvania: “In this study, we describe the development and delivery of a report card that summarized antipsychotic prescribing to publicly-insured youth in Philadelphia, which was introduced by a Medicaid managed care organization in 2020. In addition to measuring aggregate prescribing behavior, the report card included different elements of care plans, including whether youth were receiving polypharmacy, proper medication management, and the concurrent use of behavioral health outpatient services. The A/F initiative elicited feedback from clinicians, which we refer to as an ‘audit and feedback loop.’ We also evaluate the impact of the report card by comparing pre-post differences in prescribing measures for clinicians who received the report card with a group of clinicians who did not receive the report card. Report cards indicated that many youth who were prescribed antipsychotics were not receiving proper medication management or using behavioral health outpatient services alongside the antipsychotic prescription, but that polypharmacy was rare. In their feedback, clinicians who received report cards cited several challenges related to antipsychotic prescribing, such as the logistical difficulties of entering lab orders and family members’ hesitancy to change care plans. The impact of the report card was mixed: there was a modest reduction in the share of youth receiving polypharmacy following the receipt of the report card, while other measures did not change. However, we documented a large reduction in the number of youth with one or more antipsychotic prescription fill among clinicians who received a report card.”

According to the news editors, the research concluded: “A/F initiatives are a common approach to improving the quality of care, and often target specific practices such as antipsychotic prescribing. Report cards are a low-cost and feasible intervention but there is room for quality improvement, such as adding measures that track medication management or eliciting feedback from clinicians who receive report cards. To ensure that the benefits of antipsychotic prescribing outweigh its risks, it is important to promote quality and safety of antipsychotic prescribing within a broader care plan.”

For more information on this research see: Incorporating clinician insight and care plans into an audit and feedback initiative for antipsychotic prescribing to Medicaid-enrolled youth in Philadelphia. BMC Health Services Research, 2024,24(1):1-8. (BMC Health Services Research - http://bmchealthservres.biomedcentral.com). The publisher for BMC Health Services Research is BMC.

A free version of this journal article is available at https://doi.org/10.1186/s12913-024-11029-5.

Our news journalists report that more information may be obtained by contacting Molly Candon, Penn Center for Mental Health, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania. Additional authors for this research include Siyuan Shen, Aileen Rothbard, Abigail Reed, Mia Everett, Neal Demp, Melissa Weingartner, Oluwatoyin Fadeyibi.

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