JEFFERSON CITY, Mo., Dec. 17 The Missouri BehavioralPharmacy Management Program (BPM) has been selected by the Substance Abuse andMental Health Services Administration (SAMHSA) to receive one of theirprestigious 2008 Science and Service Awards. These awards "recognizeexemplary implementation of evidence-based interventions that have been shownto prevent and/or treat mental illnesses and substance abuse"(1).
The program is a partnership between the Missouri Department of MentalHealth, the Missouri Department of Social Services - MO HealthNet Division,and Comprehensive NeuroScience, Inc. (CNS). Eli Lilly and Company providedfunding for the initial pilot project. John Docherty, M.D., founder and CEOof CNS, a national clinical research company, remarked, "We are pleased thatSAMHSA has recognized this program as innovative and a sound practice in thetreatment of mental illness."
For the past five years, the BPM has been improving the psychiatricmedication prescribing practices of thousands of Missouri physicians. Usingextensive pharmacy data mining and the application of rigorously developedQuality Indicators(TM), the BPM focuses on prescribers who practice outside ofevidence-based or best practice standards including areas such as prescribingmultiple medications from the same therapeutic class, prescribing above orbelow recommended dosing levels, or premature or rapid switching from onemedication to another. In addition, providers are also alerted to instancesof duplicative prescribing of medication by other doctors for their patients,and failure of their patients to fill their prescriptions in a timely fashion.
John Docherty of CNS explains the design of the program: "A data-richeducational mailing aims to impart knowledge of best practices inpharmacotherapy for mental and behavioral health disorders. It offersprescribers clear, simple suggestions for improving the quality of treatment,as well as carefully crafted Clinical Considerations based on publishedliterature or consensus expert opinion." Physicians who continue to experiencethe same issues over time are offered a peer consultation to discussprescribing practices.
A voluntary program, the BPM protects patient-physician autonomy in makingindividual clinical decisions, and it avoids unintended consequences of othermore intrusive or aggressive cost-containment strategies(2) while stillshowing a positive impact on not just costs but on quality of care. As aresult, Missouri has realized better treatment adherence, reducedinappropriate medication usage, and reduced hospitalizations for manythousands of patients, resulting in millions of dollars saved in healthcarecosts.
"This is a model on how states can increase the quality of care thatMedicaid residents with severe mental illnesses receive while encouraging moreefficient use of taxpayer dollars," said Joseph Parks, M.D., Medical Directorof Missouri's Department of Mental Health. "Through this project, manyopportunities for coordination of care have been identified, resulting inimproved quality of care and enhanced quality of life for persons with mentalillness."
George Oestreich, Pharm.D., MPA, Deputy Director of MO HealthNet, agrees:"You really have to look at the total healthcare impact to understand what adifference improving quality can make. We know that educating physicians onprescribing patterns for drugs that treat mental illness is an excellent wayto improve the overall quality of mental health treatment within our Medicaidprogram."
The Missouri BPM averages 1,900 adult and child prescriber interventionsand 7,400 patients touched per month. In addition, based on the Missourimodel and results, BPM is now operating in 22 state Medicaid agencies and hasalso been expanded to Medicare and commercial markets.
(1) SAMHSA Announces 2008 Science and Service Award Winners, October 22,2008 News Release. http://www.samhsa.gov/newsroom/advisories/0810222125.aspx.
(2) Ning A, Dubin WR, Parks JJ. Pharmacy costs: Finding a role forquality. Psychiatric Services, 2005; 56:909-11.
SOURCE The Missouri Behavioral Pharmacy Management Program