An Evaluation of a Multidisciplinary Pediatric Behavioral Health Medication Initiative Workgroup’s Interventions on Medication Prescribing in a Population of Medicaid Patients

Wednesday, August 1, 2018
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Ashley N. Camilo, PharmD, MBA
CVS Health
Neha Kashalikar, PharmD
University of Massachusetts Medical School
Thomas Pomfret, PharmD, MPH, BCPS
Commonwealth Medicine
Kimberly Lenz, PharmD
Commonwealth Medicine
Joel Goldstein, MD
Massachusetts Department of Mental Health
Karen Clements, ScD
Commonwealth Medicine
Michael C. Angelini, MA, PharmD, BCPP
Massachusetts College of Pharmacy and Health Sciences University
Patricia Leto, PharmD
University of Massachusetts Medical School
Paul L. Jeffrey, PharmD
Commonwealth Medicine

The Massachusetts Medicaid Pharmacy Program implemented the Pediatric Behavioral Health Medication Initiative to combat concerns around pediatric behavioral health medication prescriptions. The initiative proactively required prior authorization for specific behavioral health medications and combination regimens. Review of complex cases is retroactively conducted by a multidisciplinary therapeutic class management workgroup that also conducts prescriber outreach in Massachusetts. 

Researchers from UMass Medical School performed a retrospective evaluation of the therapeutic class management workgroups peer-to-peer telephonic consultation recommendation outcomes. Their objective was to find the number of accepted and rejected recommendations as well as prescriber satisfaction with their consultation. The team reviewed a total of 70 cases within a Medicaid population and found 31.4% resulted in an accepted recommendation, 44.3% resulted in a modified acceptance, and 24.3% were rejected. These findings rose questions about the influencing factors in recommendation acceptance, which researchers concluded deserved further investigation. 

The Massachusetts Medicaid Pharmacy Program, MassHealth, is managed by UMass Medical School.