Characteristics of Medicaid Recipients Receiving Persistent Antipsychotic Polypharmacy

• Authors: Robert Cotes, Emory University; David Goldsmith, Emory University; Sarah L. Kopelovich, University of Washington; Cathy A. Lally, Emory University; Benjamin Druss, Emory University
• Journal Title: Community Mental Health Journal
• Volume: Volume 54, Number 6
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals | 2018-08-01, Pages 699-706
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s10597-017-0183-y
• Subjects: Psychology, Behavioral
• Keywords: Science & Technology; Life Sciences & Biomedicine; Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry; Health Care Sciences & Services; Medicaid; Antipsychotic polypharmacy; Pharmacoepidemiology; Geographic variation; DRUG BENEFIT MANAGEMENT; 2ND-GENERATION ANTIPSYCHOTICS; COMBINATION THERAPY; SCHIZOPHRENIA CARE; DOUBLE-BLIND; CLAIMS DATA; TRENDS; CLOZAPINE; PREVALENCE; RISPERIDONE

Abstract

Antipsychotic polypharmacy (APP) is a common strategy despite guidelines advising against this practice. This article seeks to quantify the prevalence and correlates of APP using Medicaid Analytic eXtract files from 2003 to 2004. Nineteen percent of Medicaid recipients who received an antipsychotic were treated with APP. Individuals who received APP were more likely to be white, male, disabled, between the ages of 18–29, diagnosed with a psychotic disorder, and diagnosed with a higher number of psychiatric conditions. Geographic variation in APP rates was also observed. Quality improvement initiatives may help reduce APP for medically vulnerable patients.