Evidence map›Paper›PMID 30058981›Full record

Observational studyJournal of managed care & specialty pharmacy2018

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

Ashley N Chiara, Neha Kashalikar, Thomas C Pomfret, Kimberly Lenz, Donna M Faber, Joel Goldstein, Karen M Clements, Michael C Angelini, Patricia Leto, Paul L Jeffrey

Abstract readObservational Study
In one paragraph

Observational study in Journal of managed care & specialty pharmacy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial.Journal of child psychology and psychiatry, and allied disciplines · 2025
    Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ashley N Chiara1 Clinical Pharmacy Services, University of Massachusetts Medical School, Shrewsbury.
Neha Kashalikar1 Clinical Pharmacy Services, University of Massachusetts Medical School, Shrewsbury.
Thomas C Pomfret1 Clinical Pharmacy Services, University of Massachusetts Medical School, Shrewsbury.
Kimberly Lenz3 MassHealth, Quincy, Massachusetts.
Donna M Faber4 Phoenix Veterans Affairs Health Care System, Phoenix, Arizona.
Joel Goldstein5 DCF/DMH, Caring Together Initiative, Boston, Massachusetts, and Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts.
Karen M Clements6 Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury.
Michael C Angelini2 Clinical Pharmacy Services, University of Massachusetts Medical School, Shrewsbury, and MCPHS University, Boston.
Patricia Leto1 Clinical Pharmacy Services, University of Massachusetts Medical School, Shrewsbury.
Paul L Jeffrey3 MassHealth, Quincy, Massachusetts.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn response to concerns surrounding pediatric behavioral health medication prescribing, the Massachusetts Medicaid Pharmacy Program implemented a Pediatric Behavioral Health Medication Initiative (PBHMI), proactively requiring prior authorization for specific behavioral health medications and combination regimens. A multidisciplinary therapeutic class management (TCM) workgroup retrospectively reviews complex cases and conducts prescriber outreach to encourage evidence-based practices in Massachusetts.

objectiveTo evaluate recommendation outcomes of telephonic peer-to-peer consultations conducted by the PBHMI TCM workgroup by assessing the percentage of accepted, modified accepted, or rejected recommendations, as well as prescriber satisfaction with consultation.

methodsThis retrospective evaluation reviewed PBHMI TCM workgroup cases with completed peer-to-peer consultations from September 1, 2015, to August 28, 2016. The proportion of medication interventions (e.g., medication changes, dose reductions, and elimination of polypharmacy within or across behavioral health medication classes) accepted, modified accepted, or rejected were assessed based on pharmacy claims data and prior authorization resubmission, following a peer-to-peer consultation. The medication class and prescriber type were categorized in relation to the acceptance, modified acceptance, or rejection outcomes. Satisfaction with the TCM workgroup process was evaluated with an anonymous survey offered to prescribers who participated in prescriber outreach.

resultsA total of 70 cases requiring a peer-to-peer consultation by a TCM workgroup child/adolescent psychiatrist had a completed outreach attempt during the evaluation period. Peer-to-peer consultations resulted in a recommendation acceptance rate of 31.4% (22/70), modified acceptance rate of 44.3% (31/70), and a rejection rate of 24.3% (17/70). Recommendations made during a peer-to-peer consultation were rejected by 30% (12/40) of child/adolescent psychiatrists compared with 16.7% (5/30) of nonchild/adolescent psychiatrists with completed peer-to-peer consultations (P = 0.43). Antipsychotics were most frequently recommended for regimen changes. All recommendations pertaining to a benzodiazepine were accepted by the prescriber. Results of an anonymous prescriber survey assessing satisfaction with the peer-to-peer consultation process exhibited variable responses among individual prescribers.

conclusionsThe small sample size in this observational evaluation and lack of a defined control group prevented direct associations between the endpoints and outcomes. Further research is required to determine if prescriber specialty and medication class may be influencing factors on recommendation acceptance. DISCLOSURES: No outside funding supported this study. The authors have nothing to disclose. A poster of this project was presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting 2017; March 27-30, 2017; in Denver, CO.

Indexed as

AdolescentChildDrug PrescriptionsEvidence-Based MedicineFemaleHumansMaleMassachusettsMedicaidMedication Therapy ManagementMental DisordersPolypharmacyPractice Patterns, Physicians'Program EvaluationPsychiatryPsychotropic DrugsPsychotropic Drugs

Identifiers

PMID30058981
PMCPMC10398286

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.