The Wennberg International Collaborative, London, 2-4 September 2015
|
|
- Alan Townsend
- 5 years ago
- Views:
Transcription
1 The Wennberg International Collaborative, London, 2-4 September 2015 Diagnosis and Treatment of Dementia Variation in ambulatory care for patients in Germany with special reference to non-institutionalized patients (work in progress; unpublished parts not to be cited) Dr. Dominik von Stillfried, Dr. Mandy Schulz et al Zentralinstitut für die Kassenärztliche Versorgung in Deutschland
2 Objective to explore present state of care for patients with dementia who live at home (fast growing patient group) to identify the potential for systematic improvement of care by analysing deviations from guideline recommendation (diagnosis, medication) describing regional patterns where to act? analysing utilization and behavioral patterns, in particular using network analysis to compare patient care by type of main provider rationale: with whom do we need to talk about what? see published reports concerning diagnostic process / medication for dementia patients in Germany on SEITE 2
3 Data nationwide claims data bases containing 100% of all statutorily insured patients (~ 70 million) 100% of physician claims (~ 550 million cases p.a.), i.e. of GPs and office-based specialists (~ practices) & ER claims by hospitals for patients not admitted to inpatient care 100% of filled prescriptions (~ 600 million prescriptions p.a.) data selected for patients > 60 years, confirmed dementia dx (at least in two quarters of a year) as documented by GP and/or Neurologist/Psychiatrists (NP) only (analysis of diagnostic process) and by GP and/or all specialties resp. (analysis of medication), years 2009, 2010, 2011 join of selected dx with prescription data (anti-dementive, anti-psychotic, hypnotic/sedative, anti-depressant drugs) not available: hospital claims for inpatient care or ambulatory surgery claims by logotherapist, ergotherapists etc. SEITE 3
4 Selected Dementia-Diagnoses, Prevalenc/Incidence 1. Alzheimer s dementia (AD) F00.x, G30.x 2. Vascular dementia (VD) F01.x 3. Other dementia with specific etiology F02.0, F02.3, G31.0, G Other dementia with non-specific etiology F03, G31.1, G Combinations of 1-4 Definitions according to Kaduskiewicz H et al 2013 Prevalent patients: n= ( F, M) in 2009 Incident patients: n= ( F, M) without dx in 2008 (for analysis of diagnostic process) N.B. for analysis of medication a slightly different dataset was used which did not allow to focus on diagnoses documented by GP and NP or to differentiate non-institutionalized patients (prevalent patients: 2009: n = (Hamburg excluded due to missing data), 2010: n = ; 2011: n = ) SEITE 4
5 Prevalence/Incidence (Rates) including institutionalized patients SEITE 5
6 Prevalence/Incidence (Regional Distribution) including institutionalized patients SEITE 6
7 Who sees whom? incident non-institutionalized patients Incident patients GP only specialist only GP+specialist group practice Alzheimer 7.7% 27.7% 9.2% 12.3% Vascular 14.1% 21.9% 2.8% 9.3% other specific 1.0% 5.6% 0.3% 2.1% other non- specific 66.9% 29.9% 16.6% 33.8% combinations 10.3% 14.9% 71.1% 42.5% total 100% 100% 100% 100% n=133,644 patients, year 2009 variation in coding between GP/specialists confounds potential variation in utilization patterns SEITE 7
8 Diagnostic Process incident non-institutionalized patients Incident patients all GP only specialist only GP+specialist group practice m f m f m f m f m f lab tests neuropsychiatric tests imaging n=133,644 patients, year 2009 Diagnostic intensity varies with utilization pattern: - patients seen by GP only may receive insufficient diagnostic testing - patients seen by both GP and specialist are most intensely diagnosed - there is room for increased neuropsychiatric testing Irrespective of utilization there is a consistent gender pattern (f < m) SEITE 8
9 Diagnostic Process moderate regional variation suggesting partially substitutive effects Percent of incident patients diagnosed with lab tests neuropsychiatric tests imaging SEITE 9
10 Medication: underuse of antidementives/overuse of antipsychotics? N.B. m/f ratio reversed, distinctive regional pattern percent of medication patients antidementive antipsychotic hypnotic/sedative antidepressant m f type of dementia Alzheimer vascular other specific other non- specific combination utilization GP only specialist only GP+specialist other region large city metropolitan rural near city rural unknown total N=1,014,710 prevalent patients in 2011 SEITE 10
11 Network analysis network nucleus: patients have been attributed to primary care physician who delivered most services to this patient irrespective of diagnoses all other GPs or specialists contacted by the patient form a virtual provider network with this primary care physician networks with very few patients (N <10) were exluded dementia patients: all prevalent patients in 2011 attributed to a network (N = 838,125) dementia networks : problems of small numbers and uneven distribution of dementia patients SEITE 11
12 prevalent dementia patients in virtual provider networks N=838,125 (2011) 120 Number of dementia patients per virtual provider network % of virtual provider networks 90% of virtual provider networks 99% of virtual provider networks Number of prevalent dementia patients Up to 19 Up to 50 Up to 103 MIN 1 MAX % 10% 20% 30% 40% 50% 60% 70% 80% 90% 99% Frequency (percentiles) * Networks with 10 patients or less were SEITE 12 Wennberg International Collaborative excluded, London, 2-4 September 2015
13 Number of incident* dementia patients in virtual provider networks N=233,354 (2011) *without dementia dx in 2009 and in 2010 Number of incident dementia patients Number of dementia patients per virtual provider network 50% of virtual provider networks 90% of virtual provider networks 99% of virtual provider networks Up to 6 Up to 14 Up to 30 MIN 1 MAX 217 networks without incident dementia patients have significantly fewer prevalent dementia patients frequency (percentiles) SEITE 13
14 Regional Variation in the distribution of network populations size marked differences between regions but no discernable pattern according to area type or provider structure SEITE 14
15 Diagnostic approach according to type of network percent of patients receiving neuropsychiatric testing type of network GP Neurolog ist Psychiatr ist Group practice total CT MRT <10 incident dementia patients incident dementia patients 50% percentile of networks 90% percentile of networks 18,10% 6,60% 5,10% 9,60% 39,40% 9,60% 8,10% 22,30% 4,80% 4,30% 7,90% 39,40% 9,80% 7,10% >20 incident dementia patients 99% percentile of networks 48,30% 2,00% 2,20% 5,00% 57,50% 9,30% 6,30% incident dementia patients without patients in long term care facilities, N= (2011) role of GP and importance of neuropsychiatric testing increase with no. of dementia patients SEITE 15
16 Prescription rates vary according to population size of virtual network (rates fall as population size increases) prevalent patients large (>100 prevalent size of functional population medium ( prevalent small (<50 prevalent total Anti-dementive drugs 16.9% 21.4% 26.5% 24.7% Antipsychotics 34.0% 36.4% 35.6% 35.7% Hypnotics/sedatives 9.1% 9.3% 9.3% 9.3% Antidepressants 28.5% 29.7% 29.5% 29.5% n=838,125, including institutionalized patients (2011) size of functional population incident patients large (>30 incident medium (14-30 incident small (<14 incident total Anti-dementia drugs 13.6% 21.8% 26.4% 24.4% Antipsychotics 27.5% 33.1% 32.2% 32.5% Hypnotics/sedatives 9.4% 9.8% 9.6% 9.7% Antidepressants 28.3% 31.0% 30.5% 30.5% n=233,354, including institutionalized patients (2011) SEITE 16
17 Taking a look at the networks - how important are dementia patients within the network population? networks share of dementia patients (in all patients of the network) large (>100 prevalent size of functional population medium ( prevalent small (<50 prevalent total high (share >10%) medium (share 4-10%) 223 1,903 3,599 5,725 low (share <4%) 30 1,045 26,979 28,054 total 370 3,040 30,635 34,045 no of virtual networks: n=34,045 (2011) < 1 percent of provider networks (266) had a high share of dementia patients, almost half of them had > 100 dementia patients per year the vast majority (79%) of networks had a low share and a low number of dementia patients SEITE 17
18 And how important are networks with a focus on dementia? networks share of dementia patients (relative to all patients of the network) large (>100 prevalent size of functional population medium ( prevalent small (<50 prevalent total high (share >10%) 19,275 7,057 1,659 27,991 medium (share 4-10%) 28, , , ,919 low (share <4%) 3,407 65, , ,215 total 51, , , ,125 no. of prevalent dementia patients, n=838,125 (2011) virtual provider networks with a focus (high share and a high number of dementia patients) treat only 2.3% of all dementia patients, whereas > 50% of dementia patients were treated by networks with low share and low size. SEITE 18
19 And how important are networks with a focus on dementia? Prescription rates of anti-dementia drugs share of dementia patients (relative to all patients of the network) large (>100 prevalent size of functional population medium ( prevalent small (<50 prevalent total high (share >10%) 14.9% 17.1% 18.0% 15.7% medium (share 4-10%) 17.6% 20.5% 22.9% 21.2% low (share <4%) 22.0% 23.7% 27.4% 26.9% total 16.9% 21.4% 26.9% 24.4% no. of prevalent dementia patients, n=838,125 (2011) Networks with a focus on dementia show the lowest prescription rate of antidementia drugs ( guideline recommendation) Are these opinion leaders? Do they favor other treatment options? Do they collect specific patients (e.g. rare/serious cases, patients in long term care facilities?) What constitutes the dependence on patient population size? SEITE 19
20 And how important are networks with a focus on dementia? Prescription rates of anti-psychotic drugs share of dementia patients (relative to all patients of the network) large (>100 prevalent size of functional population medium ( prevalent small (<50 prevalent total high (share >10%) 31.5% 34.2% 34.5% 32.3% medium (share 4-10%) 35.3% 35.6% 35.0% 35.3% low (share <4%) 37.2% 38.3% 35.7% 36.0% total 34.0% 36.4% 35.6% 35.7% no of prevalent dementia patients, n=838,125 (2011) Networks with a focus on dementia show the lowest prescription rate of antipsychotic drugs, there is an effect of size and focus, but the difference is small (similar for hypnotics/sedatives and anti-depressants) What prevents a greater reduction in prescribing rates? What could other networks learn from them? SEITE 20
21 Conclusions There is room for improvement in the diagnostic process of dementia patients - in general, more cooperation between GP and specialists would be welcomed Prescription of anti-psychotics seems high given potentially dangerous effects. Prescription of anti-dementia drugs is low compared to guideline recommendations. This pattern is observed both in prevalent and in incident dementia patients. Prescription rates of anti-dementia drugs are affected by characteristics of virtual provider networks (size of functional population and share of but a focus on dementia patients leads to greater deviation from recommendations There is no clear evidence of substition with other drugs or other kinds of treatment, however, prescription of antipsychotics increases with decreasing share of dementia patients Before designing intervention: reasons for observed pattern need to be explored by communication with various network representatives SEITE 21
22 Vielen Dank für Ihre Aufmerksamkeit Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland Herbert-Lewin-Platz Berlin Tel Fax zi@zi.de SEITE 22
Longitudinal regional analyses of an1bio1c consump1on in statutory health care insured pa1ents in Germany since 2008
Longitudinal regional analyses of an1bio1c consump1on in statutory health care insured pa1ents in Germany since 2008 Jörg Bätzing- Feigenbaum - Maike Schulz - Mandy Schulz - Jana Gisbert Miralles - Dominik
More informationCOGNOS. Care for people with Cognitive dysfunction A National Observational Study. Professor Dr Jan De Lepeleire COGNOS members
COGNOS Care for people with Cognitive dysfunction A National Observational Study Professor Dr Jan De Lepeleire COGNOS members Luxembourg Alzheimer Europe 2010 The Careplan in Belgium Requirements for reimbursement
More informationPrevalence of Mental Illness
Section 1 Prevalence of Mental Illness The prevalence of mental health problems or mental illness appears to be quite stable over time. Full epidemiological surveys of prevalence, reported using complex
More informationPediatric Behavioral Health Medication Initiative Prior Authorization (PA) Request Form
Pediatric Behavioral Health Medication Initiative Prior Authorization (PA) Request Form Please fax form to 617.673.0988 or mail to Tufts Health Plan, 705 Mount Auburn Street, Watertown, MA 02472, Attn:
More informationCHCS. Multimorbidity Pattern Analyses and Clinical Opportunities: Dementia. Center for Health Care Strategies, Inc. FACES OF MEDICAID DATA SERIES
CHCS Center for Health Care Strategies, Inc. FACES OF MEDICAID DATA SERIES Multimorbidity Pattern Analyses and Clinical Opportunities: Dementia December 2010 Cynthia Boyd, MD, MPH* Bruce Leff, MD* Carlos
More informationMEDICATIONS PRESCRIPTION AT HOSPITAL DISCHARGE IN PATIENTS WITH VALIDATED DIAGNOSIS OF DEMENTIA. Federica Edith Pisa University Hospital Udine
MEDICATIONS PRESCRIPTION AT HOSPITAL DISCHARGE IN PATIENTS WITH VALIDATED DIAGNOSIS OF DEMENTIA Federica Edith Pisa University Hospital Udine BACKGROUND Polypharmacy and psychotropic medication use are
More informationPsychotropic Medication. Including Role of Gradual Dose Reductions
Psychotropic Medication Including Role of Gradual Dose Reductions What are they? The phrase psychotropic drugs is a technical term for psychiatric medicines that alter chemical levels in the brain which
More informationffice for the Study of Aging University of South Carolina, USA Presented at REVES 2005, Beijing, China
Life Expectancy for Individuals with Alzheimer s Disease or Related Disorders: Evidence of a Black / White Mortality Crossover James N. Laditka, Sarah B. Laditka With Carol B. Cornman Candace N. Porter,
More informationCost of Mental Health Care
Section 4 Cost of Mental Health Care Per capita mental health spending for Americans with a mental health diagnosis has increased among children, peaking in. For adults, the spending has been more stable.
More informationMedi Cal Managed Care. Melissa Lamer, PharmD, BCPP July 31 st, 2014
Pharmacy Benefit Carve Outs in Medi Cal Managed Care Melissa Lamer, PharmD, BCPP July 31 st, 2014 2 The Behavioral Health Carve Out Services Carved Out to the County Starting 1/1/2014 Medi Cal plans now
More informationDeveloping mental health care in Europe - what can Germany learn from Member States and how can Member States profit from German experience?
Developing mental health care in Europe - what can Germany learn from Member States and how can Member States profit from German experience? Prof. Dr. Rainer Richter De-medicalising primary mental health
More informationEKIV Newsletter 3/2010
Evaluation of Gesundes Kinzigtal Integrated Care EKIV Newsletter 3/2010 edited by Evaluations-Koordinierungsstelle Integrierte Versorgung (EKIV) Dept. of Medical Sociology Albert-Ludwigs-University Freiburg
More informationBehavioral Health Evaluation
This document is intended to serve as a template for a behavioral health committee meeting in an extended care facility. The State Operations Manual (SOM), Appendix PP - "Guidance to Surveyors for Long
More informationValue of Hospice Benefit to Medicaid Programs
One Pennsylvania Plaza, 38 th Floor New York, NY 10119 Tel 212-279-7166 Fax 212-629-5657 www.milliman.com Value of Hospice Benefit May 2, 2003 Milliman USA, Inc. New York, NY Kate Fitch, RN, MEd, MA Bruce
More informationRenewing priority for dementia: Where do we stand?
Policy brief Renewing priority for dementia: Where do we stand? Renewing priority for dementia: Where do we stand? Contents Overview 03 Putting dementia higher on the agenda 04 Diagnosing and identifying
More informationAppendix 1. Cognitive Impairment and Dementia Service Elm Lodge 4a Marley Close Greenford Middlesex UB6 9UG
Appendix 1 Mr Dwight McKenzie Scrutiny Review Officer Legal and Democratic Services Ealing Council Perceval House 14 16 Uxbridge Road Ealing London W5 2HL Cognitive Impairment and Dementia Service Elm
More informationUse of anti-psychotic medication in care homes Response from the Royal Pharmaceutical Society in Wales
Use of anti-psychotic medication in care homes Response from the Royal Pharmaceutical Society in Wales About us The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great
More information9/11/2012. Clare I. Hays, MD, CMD
Clare I. Hays, MD, CMD Review regulatory background for current CMS emphasis on antipsychotics Understand the risks and (limited) benefits of antipsychotic medications Review non-pharmacologic management
More informationDepression in Chronic Physical Health Problems FULL GUIDELINE 1
O Connor 2005 U.S.A. Sertraline Placebo Study design data source Patients who were hospitalised for acute coronary syndromes and who met the APA s DSMIV criteria for major depressive disorder (MDD). :
More informationRADIOLOGY VERSION 5. Retrospective data in full ACIR
RADIOLOGY VERSION 5 Retrospective data in full ACIR 2008-2015 Contents Radiology, version 5 1 Report availability... 1 1.1 Emergency department / critical care unit plain radiography reports (L) 1 1.2
More informationNCI Data Brief. ISSUE 6 December 2012
NCI Data Brief ISSUE 6 December 2012 What does NCI tell us about adults with intellectual and developmental disabilities who are taking prescribed medications for anxiety, behavior challenges, mood disorders
More informationBurden of behavioral and psychiatric symptoms in people screened positive for dementia in primary care results of the DelpHi-study René Thyrian
Burden of behavioral and psychiatric symptoms in people screened positive for dementia in primary care results of the DelpHi-study René Thyrian German Center for Neurodegenerative Diseases (DZNE), site
More informationSYNOPSIS. Trial No.: RIS-USA-70 Clinical phase: III. JRF, Clinical Research Report RIS-USA-70, 16 October, 1998 N Trial period: Start: 20 Nov 95
SYNOPSIS Trial identification and protocol summary Company: Janssen Research Foundation Finished product: RISPERDAL Active ingredient: Risperidone (R064,766) Title: An open-label, long-term study of risperidone
More informationUse of Anti-Psychotic Agents in Irish Long Term Care Residents with Dementia
Use of Anti-Psychotic Agents in Irish Long Term Care Residents with Dementia Aine Leen, Kieran Walsh, David O Sullivan, Denis O Mahony, Stephen Byrne, Margaret Bermingham Pharmaceutical Care Research Group,
More informationAspartate Aminotransferase Testing in Community-Based Laboratories: An Expert Consultation
Aspartate Aminotransferase Testing in Community-Based Laboratories: An Expert Consultation B McCurdy June 2013 Aspartate Aminotransferase Testing in Community-Based Laboratories. June 2013; pp. 1 11. Suggested
More informationICRU Report 91 Was ist neu, was ändert sich?
DEGRO Stereotaxie Meeting 21.10.2017 ICRU Report 91 Was ist neu, was ändert sich? Lotte Wilke, Stephanie Tanadini-Lang, Matthias Guckenberger Klinik für Radio-Onkologie, Universitätsspital Zürich History
More informationNuplazid. Nuplazid (pimavanserin) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.60.03 Subject: Nuplazid Page: 1 of 4 Last Review Date: June 22, 2018 Nuplazid Description Nuplazid (pimavanserin)
More informationDementia Strategy MICB4336
Dementia Strategy 2013-2018 MICB4336 Executive summary The purpose of this document is to set out South Tees Hospitals Foundation Trust s five year strategy for improving care and experience for people
More informationPalliative Care and End of Life Care
Palliative Care and End of Life Care Relevant Data and References Victorian Population 1 Total Victorian Population as at June 2016 was 6.1 million (6,179,249) Victorian 60 plus population as at June 2016
More informationIdentifying Adult Mental Disorders with Existing Data Sources
Identifying Adult Mental Disorders with Existing Data Sources Mark Olfson, M.D., M.P.H. New York State Psychiatric Institute Columbia University New York, New York Everything that can be counted does not
More informationRURAL HEALTH AND ITS INFLUENCE ON THE GP PERSPECTIVE OF DEMENTIA
RURAL HEALTH AND ITS INFLUENCE ON THE GP PERSPECTIVE OF DEMENTIA 14 TH NATIONAL RURAL HEALTH CONFERENCE APRIL 2017 ANGE CROMBIE, DIRECTOR RESEARCH & DEVELOPMENT Background Australia, like the rest of the
More informationDr Belinda McCall Consultant Geriatrician
Dr Belinda McCall Consultant Geriatrician Overview Background to our service Project Initial service provision Further developments Benefits of a geriatrician Questions Background National Dementia Strategy
More informationPrescribing medications for people with a personality disorder A service evaluation of a community mental health team
Prescribing medications for people with a personality disorder A service evaluation of a community mental health team Dr Umama Khan, Consultant Psychiatrist Dr Venkatesh Ballagere, Specialist Registrar
More informationUnitedHealthcare Community (UHCCP) Louisiana Clinical Program Guidelines Record Supplemental Tool
December-18 UnitedHealthcare Community (UHCCP) Louisiana Clinical Program Guidelines Record Supplemental Tool Facility Name: Primary Dx: Member Gender: Member Age: Reviewer Name: Date of Facility Review:
More informationThe place for treatments of associated neuropsychiatric and other symptoms
The place for treatments of associated neuropsychiatric and other symptoms Luca Pani dg@aifa.gov.it London, 25 th November 2014 Workshop on Alzheimer s Disease European Medicines Agency London, UK Public
More informationManchester Self-Harm Project MaSH
MaSH Manchester Self-Harm Project MaSH 6 th Year Report 1 st September 2002 to 31 st August 2003 Jayne Cooper, Amy Johnston, Maria Healey, Iain Donaldson, Harriet Bickley, Navneet Kapur, Louis Appleby
More informationYoung onset dementia service Doncaster
Young onset dementia service Doncaster RDaSH Older People s Mental Health Services Introduction The following procedures and protocols will govern the operational working and function of the Doncaster
More information2014 Evidence-Based HTN Guideline: Preliminary Data from AMGA s Anceta Collaborative
2014 Evidence-Based HTN Guideline: Preliminary Data from AMGA s Anceta Collaborative February 2014 Patient Population Measure spec for MU/PD generally follows NQF 0018 (used for HEDIS, PQRS, and MU) 1.6
More informationHow do we sustain acceptance in societies with mandates: The situation in Germany
How do we sustain acceptance in societies with mandates: The situation in Germany Sabine Reiter, Federal Ministry of Health Les Pensières, 25-27 September 2017 26.09.2017 Seite 1 Structure of german health
More informationAntipsychotic Prior Authorization Request
Antipsychotic Prior Authorization Request Commonwealth of Massachusetts MassHealth Drug Utilization Review Program P.O. Box 2586, Worcester, MA 01613-2586 Fax: 1-877-208-7428 Phone: 1-800-745-7318 MassHealth
More informationAlzheimer s Society. Consultation response. Our NHS care objectives: A draft mandate to the NHS Commissioning Board.
Alzheimer s Society Our NHS care objectives: A draft mandate to the NHS Commissioning Board 26 September 2012 Delivering Dignity Securing dignity in care for older people in hospitals and care homes: A
More informationNumber of records submitted: 14,750 Number of participants: Part 1 = 146 hospitals (120 trusts); Part 2 = 140 hospitals (119 trusts)
British Thoracic Society Smoking Cessation Audit Report Smoking cessation policy and practice in NHS hospitals National Audit Period: 1 April 31 May 2016 Dr Sanjay Agrawal and Dr Zaheer Mangera Number
More informationIntegrating Behavioral Health into Primary Care: Collaborative-Care Models
Integrating Behavioral Health into Primary Care: Collaborative-Care Models Presented at the National Health Policy Forum September 17 th, 2013 Marc Avery, MD Clinical Associate Professor Associate Director
More informationScreening and Management of Behavioral and Psychiatric Symptoms Associated with Dementia
Screening and Management of Behavioral and Psychiatric Symptoms Associated with Dementia Measure Description Percentage of patients with dementia for whom there was a documented screening* for behavioral
More informationConnecticut Medicaid Emerging Adults
Connecticut Medicaid Emerging Adults Child/Adolescent Quality, Access & Policy Committee April 18, 2018 Christopher Bory, PsyD, Beacon Health Options Agenda 1. National Context a. Gap in understanding
More informationVO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT)
VO- PMHP Treatment Guideline 102: Electroconvulsive Therapy (ECT) Diagnostic Guidelines: Introduction: Electroconvulsive Therapy has been in continuous use for more than 60 years. The clinical literature
More informationKey Findings and Recommendations from the
June 2014 Improving Community Health Through Policy Research Key Findings and Recommendations from the 2013 IPLA INSPECT Knowledge and Use Survey 2014 Center for Health Policy (14-H54) IU Richard M Fairbanks
More informationMina Tadrous, Diana Martins, Zhan Yao, Kimberly Fernandes, Samantha Singh, Nikita Arora, David Juurlink, Muhammad Mamdani and Tara Gomes
Cognitive Enhancers Pharmacoepidemiology Report: FINAL CENSORED Report Mina Tadrous, Diana Martins, Zhan Yao, Kimberly Fernandes, Samantha Singh, Nikita Arora, David Juurlink, Muhammad Mamdani and Tara
More informationResearch Protocol for REAP Bipolar Disorder (REAP-BD)
Research Protocol for REAP Bipolar Disorder (REAP-BD) Summary REAP-BD survey will focus on the prescription patterns on bipolar disorder. Both inpatients and outpatients with bipolar disorder will be enrolled.
More informationBuilding Quality Into Outpatient Dementia Care For Mainers
Building Quality Into Outpatient Dementia Care For Mainers Cliff Singer MD Chief, Geriatric Mental Health and Neuropsychiatry Principal Investigator, Alzheimer s Disease Clinical Research Program Acadia
More informationExecutive Summary. The Royal Australasian College of Physicians July 2012 Page 1 of 5
PBAC Review of Pharmaceutical Benefits Scheme anti-dementia drugs to treat Alzheimer s disease Submission by The Royal Australasian College of Physicians July 2012 The Royal Australasian College of Physicians
More informationFL Medicaid Drug Therapy Management Program for Behavioral Health Monitoring for Safety and Quality
FL Medicaid Drug Therapy Management Program for Behavioral Health Monitoring for Safety and Quality April 23, 2014 Pensacola, FL Presentation Objectives To briefly describe the program and how its components
More informationBringing machine learning to the point of care to inform suicide prevention
Bringing machine learning to the point of care to inform suicide prevention Gregory Simon and Susan Shortreed Kaiser Permanente Washington Health Research Institute Don Mordecai The Permanente Medical
More informationSocial inequalities in dementia care, cure, and research
Online 4 April 2017 at the Journal of the American Geriatrics Society, doi: 10.1111/jgs.14893 AUTHOR POST-PRINT Social inequalities in dementia care, cure, and research Anja K. Leist, PEARL Institute for
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #283: Dementia Associated Behavioral and Psychiatric Symptoms Screening and Management National Quality Strategy Domain: Effective Clinical Care 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY
More informationUrological cancers why we need to change. Stakeholder workshop 14 March 2013
Urological cancers why we need to change Stakeholder workshop 14 March 2013 Introduction and welcome Today s event aims to cover: 1. Background, clinical evidence and London Cancer s recommendations Q&As
More informationBuilding a learning healthcare system for suicide prevention
Building a learning healthcare system for suicide prevention Gregory Simon MD MPH Kaiser Permanente Washington Health Research Institute Mental Health Research Network Depression and Bipolar Support Alliance
More informationIn addition, we have asked an English-editing service to edit the text, and you will find an English-edited version of the paper submitted as well.
Author s response to reviews Title: Resource Use and Disease Course in Dementia - Nursing Home (REDIC-NH): A Norwegian Cohort Study from Admission to a Nursing Home until Death. A description of study
More informationLowering epilepsy-related treatment costs in the era of patient choice and value-based care
Lowering epilepsy-related treatment costs in the era of patient choice and value-based care In-home EEG offers cost-effective, reliable alternative to traditional diagnostic services 01 Introduction One
More informationThe STOP Measure. Safe and Transparent Opioid Prescribing to Promote Patient Safety and Reduced Risk of Opioid Misuse FEBRUARY 2018
The STOP Measure Safe and Transparent Opioid Prescribing to Promote Patient Safety and Reduced Risk of Opioid Misuse FEBRUARY 2018 AHIP s Safe, Transparent Opioid Prescribing (STOP) Initiative Methodology
More informationOPIOID USE DISORDER AND THE PSYCHIATRIC EMERGENCY ROOM THE VA CT MODEL
OPIOID USE DISORDER AND THE PSYCHIATRIC EMERGENCY ROOM THE VA CT MODEL Brian Fuehrlein, MD PhD VA Connecticut Healthcare System and Yale University I have no conflicts of interest or relevant financial
More informationTESTIMONY Of Pam Gehlmann Executive Director/ Assistant Regional Director Pinnacle Treatment Centers Alliance Medical Services-Johnstown
TESTIMONY Of Pam Gehlmann Executive Director/ Assistant Regional Director Pinnacle Treatment Centers Alliance Medical Services-Johnstown Center for Rural Pennsylvania On Confronting the Heroin Epidemic
More informationDebra Brown, PharmD, FASCP Pharmaceutical Consultant II Specialist. HMS Training Webinar January 27, 2017
Debra Brown, PharmD, FASCP Pharmaceutical Consultant II Specialist HMS Training Webinar January 27, 2017 1 Describe nationwide prevalence and types of elderly dementia + define BPSD Define psychotropic
More informationEvaluation of a Medicaid Psychotropic Drug Management Program in Utah
Evaluation of a Medicaid Psychotropic Drug Management Program in Utah Dominick Esposito James M. Verdier 2008 SAMHSA/CMS Invitational Conference on Medicaid and Mental Health Service/Substance Abuse Treatment
More informationAsthma and COPD in Switzerland: Prevalence and direct medical costs according to health insurance claims data
WENNBERG INTERNATIONAL COLLABORATIVE SPRING POLICY MEETING 2018 Asthma and COPD in Switzerland: Prevalence and direct medical costs according to health insurance claims data Marion Schmidt 1, Roland Rapold
More informationIllinois CHIPRA Medical Home Project Baseline Results
Illinois CHIPRA Medical Home Project Baseline Results On the National Committee for Quality Assurance Patient Centered Medical Home Self-Assessment June 25, 2012 Prepared by MetroPoint Research & Evaluation,
More informationBased on Medicare FFS Beneficiaries Assigned July 1, 2011 December 31, 2011
July 2012 Multi-payer Advanced Primary Care Practice (MAPCP) Demonstration Medical Home Feedback Report Based on Medicare FFS Beneficiaries Assigned July 1, 2011 December 31, 2011 Practice Number Practice
More informationTaking Care: Child and Youth Mental Health PSYCHOSIS TREATMENT OPTIONS
Taking Care: Child and Youth Mental Health PSYCHOSIS TREATMENT OPTIONS Open Learning Agency 2004 TREATMENT OPTIONS Psychosis is highly treatable, especially if caught early. The prognosis for recovery
More informationNQF Behavioral Health Project Phase II Submitted Measures
0103 Major Depressive Disorder (MDD): Diagnostic Evaluation Percentage of patients aged 18 years and older with a new diagnosis or recurrent episode of MDD who met the DSM-IV criteria during the visit
More informationOrganization: Sheppard Pratt Health System Solution Title: Lean Methodology: Appropriate Antipsychotic Use on an Inpatient Dementia Unit
Organization: Sheppard Pratt Health System Solution Title: Lean Methodology: Appropriate Antipsychotic Use on an Inpatient Dementia Unit Problem: For dementia patients, antipsychotic medications are prescribed
More informationHospital Discharge Data
Hospital Discharge Data West Virginia Health Care Authority Hospitalization data were obtained from the West Virginia Health Care Authority s (WVHCA) hospital discharge database. Data are submitted by
More informationUniversity of South Florida OCD, Anxiety, and Related Disorders Behavioral Treatment Program
OCD and Related Disorders Clinic Profile University of South Florida OCD, Anxiety, and Related Disorders Behavioral Treatment Program Clinic/Program Director: Adam B. Lewin, PhD, ABPP Name of Intake Coordinator:
More informationCoordinated Specialty Care: A New Approach to Addressing Emerging Serious Mental Illness in Young Adults
Coordinated Specialty Care: A New Approach to Addressing Emerging Serious Mental Illness in Young Adults Rhonda Thissen, M.S.W. DBHDS Office of Adult Community Behavioral Health DBHDS Vision: A life of
More informationCerebral Stimulant and ADHD Drugs Prior Authorization Request
Commonwealth of Massachusetts MassHealth Drug Utilization Review Program P.O. Box 2586, Worcester, MA 01613-2586 Fax: 1-877-208-7428 Phone: 1-800-745-7318 Cerebral Stimulant and ADHD Drugs Prior Authorization
More informationThe effect of continuity of ambulatory care on hospitalizations in patients with heart failure
The effect of continuity of ambulatory care on hospitalizations in patients with heart failure DGGÖ 17.03.2014 Verena Vogt 1, Diana Kurch-Bek 2, Leonie Sundmacher 3 1 Fachgebiet Management im Gesundheitswesen,
More informationDementia Benchmarking Indicators Definitions and Data Sources Manual
Indicators Definitions and Data Sources Manual (September 2015) 1 Contents Page Number Dementia Indicators 3 Indicator Summary Tables 4 General Notes 22 Glossary 23 Appendix 1 Dementia Criteria 24 2 Indicators
More information-Guidelines for the discontinuation of oral antipsychotics in patients with BPSD within the primary care setting Summary- Quetiapine
-Guidelines for the discontinuation of oral antipsychotics in patients with BPSD within the primary care setting Summary- Quetiapine An independent report Time for action 1 by Professor Sube Banerjee looked
More informationOutpatient use of Atypical Antipsychotic Agents in the Pediatric Population Years
Outpatient use of Atypical Antipsychotic Agents in the Pediatric Population Years 2004-2008 Laura Governale, Pharm.D., MBA Team Leader, Drug Utilization Data Analyst Hina Mehta, Pharm.D. Drug Utilization
More informationAntidepressant Prior Authorization Request
Antidepressant Prior Authorization Request Commonwealth of Massachusetts MassHealth Drug Utilization Review Program P.O. Box 2586, Worcester, MA 01613-2586 Fax: 1-877-208-7428 Phone: 1-800-745-7318 MassHealth
More informationWorcestershire Dementia Strategy
Worcestershire Dementia Strategy An Easy Read Summary Introduction This is a plan about how we will support people with dementia, their families and carers in Worcestershire. This is called the Worcestershire
More informationFriend or Foe? Review of the Regulations & Benefits: Risk Profiles of the Benzodiazepines
Friend or Foe? Review of the Regulations & Benefits: Risk Profiles of the Benzodiazepines Program Learning Objectives At the conclusion of the activity, participants should be able to: Have a basic understanding
More informationDepression Disease Navigation
Depression Disease Navigation The depression disease navigation program is designed to reach out to members who have been diagnosed with major depression disorder. This is accomplished by promoting treatment
More informationAlcohol Opiates Other:
Pages 1 and 2 must be completed in full for all referrals (incomplete forms will not be processed) Additional Required Information Form must be completed for all referrals Medication Clinic (Pg. 3), ECT
More informationCARE NEEDED: Improving the lives of people with dementia. Francesca Colombo Head of the OECD Health Division London, 12 June 2018
CARE NEEDED: Improving the lives of people with dementia Francesca Colombo Head of the OECD Health Division London, 12 June 2018 Dementia affects million of people in OECD, and the numbers will continue
More informationLCA Mental Health & Psychological Support Mapping
LCA Mental Health & Psychological Support Mapping November 2013 Contents 1 Introduction... 3 2 Method... 3 3 Results... 3 3.1 Information Centres... 3 3.2 Training and Education... 5 3.3 Level Two Supervision...
More informationUnmanaged Behavioral Health Puts Your Company At Risk. Presented by: Dr. Sam Mayhugh Integrated Behavioral Health
Unmanaged Behavioral Health Puts Your Company At Risk Presented by: Dr. Sam Mayhugh Integrated Behavioral Health Behavioral Health Management Webinar Overview History of BH management Prevalence of behavioral
More informationAnticonvulsant Prior Authorization Request
Anticonvulsant Prior Authorization Request Commonwealth of Massachusetts MassHealth Drug Utilization Review Program P.O. Box 2586, Worcester, MA 01613-2586 Fax: 1-877-208-7428 Phone: 1-800-745-7318 MassHealth
More informationMental Health Cardiff University
Mental Health research @ Cardiff University Strong focus on integrated, multilevel mechanistic understanding based on inter-disciplinarity Driven by human genetics, aimed to deliver knowledge spanning
More informationDIGNITY IN DEMENTIA. G7 dementia legacy event Japan 6 th November 2014
G7 dementia legacy event Japan 6 th November 2014 DIGNITY IN DEMENTIA How better policy can improve the lives of people with dementia Mark Pearson Deputy Director Directorate for Employment, Labour and
More informationNew Mexico. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile New Mexico Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationResponse to Concerns of NQF Neurology Steering Committee
November 30, 2012 6312 Old Keene Mill Court Springfield, VA 22152 Phone: 703-690-1987: www.pqaalliance.org Fax: 703-690-1756 To: National Quality Forum From: David Nau, PhD, RPh, CPHQ, FAPhA Senior Director,
More informationMental Health Current Articles Bulletin - April 2017
Library and Knowledge Services Mental Health Current Articles Bulletin - April 2017 Please see below for recent articles found in our print journal collection that may be of interest Alcohol and Substance
More informationThe NYC Elder Abuse Center
The NYC Elder Abuse Center Brooklyn Geriatric Mental Health and Medical Provider Survey You can also complete this survey online: http://www.surveymonkey.com/s/geriatricproviders PLEASE PRINT CLEARLY Preamble
More informationNHS RightCare Frailty Pathway An optimal frailty system
NHS RightCare Frailty Pathway An optimal frailty system Martin Vernon National Clinical Director for Older People Adrian Hopper Consultant Physician & Frailty Pathway GiRFT Lead Alex Thompson Pathways
More informationAppendix K: Evidence review flow charts
K.1 Dementia diagnosis K.1.1 Dementia diagnosis What are the most effective methods of primary assessment to decide whether a person with suspected dementia should be referred to a dementia service? What
More informationSADAG submission to the Competition Commission: Market Inquiry into the Private Healthcare Sector
THE SOUTH AFRICAN DEPRESSION AND ANXIETY GROUP NPO 013-085 Reg. No. 2000/025903/08 P O Box 652548 Benmore 2010 Tel: +27 11 234 4870 Fax: +27 11 234 8182 office@anxiety.org.za www.sadag.org SADAG submission
More informationIEHP UM Subcommittee Approved Authorization Guidelines Electroconvulsive Therapy- ECT
Electroconvulsive Therapy- ECT Policy: IEHP considers ECT medically necessary for members with the following disorders: 1. Unipolar and bipolar depression. 2. Bipolar mania. 3. Psychotic disorders including
More informationAccess to Essential Medicines for MNS Disorders with the Greatest Burden: Focus on Depression, Psychosis and Epilepsy
Access to Essential Medicines for MNS Disorders with the Greatest Burden: Focus on Depression, Psychosis and Epilepsy Atalay Alem, MD, PhD Department of Psychiatry, School of Medicine, College of Health
More informationDEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease
What is PRESENTS DEMENTIA? WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: Memory Reasoning Planning Learning Attention Language Perception Behavior AS OF 2013 There
More informationPerformance Indicator Trending Report
MICHIGAN MISSION-BASED PERFORMANCE INDICATOR SYSTEM CMHSP Performance Indicator Trending Report FY 15 FY 17 updated August 217 Indicator 1: ACCESS-TIMELINESS/INPATIENT SCREENING: The percentage of persons
More information