Debra Brown, PharmD, FASCP Pharmaceutical Consultant II Specialist. HMS Training Webinar January 27, 2017
|
|
- Egbert Berry
- 5 years ago
- Views:
Transcription
1 Debra Brown, PharmD, FASCP Pharmaceutical Consultant II Specialist HMS Training Webinar January 27,
2 Describe nationwide prevalence and types of elderly dementia + define BPSD Define psychotropic medications; delineate potential antipsychotic adverse effects Identify current CMS regulatory guidance/survey tools to evaluate antipsychotic medication use Summarize the current national focus on antipsychotic reduction in nursing homes 2
3 14% of people age 71 and older in the US have dementia 60 80% of dementia cases are Alzheimer s 10% of cases are vascular dementia However, 50% of elderly with dementia have evidence of infarcts Other dementia types: Lewy Body, Parkinson s, Frontotemporal Lobar Degeneration, Creutzfeld-Jakob, Normal Pressure Hydrocephalus Source: Alzheimer s Disease 2016 Facts and Figures, Alzheimer s Association 3
4 Behavioral or Psychological Symptoms of Dementia Fluctuate over the course of dementia illness Reflects consensus by the International Psychogeriatric Association with regard to description of dementia symptom clusters, specifically: Behavioral: verbal/physical aggression, disinhibition Psychological: hallucinations, delusions, paranoia, anxiety, depressed mood, sleep disturbance 4
5 5
6 Each resident s drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used -- (1) In excessive dose (including duplicate drug therapy); or (2) For excessive duration; or (3) Without adequate monitoring; or (4) Without adequate indications for its use; or (5) In the presence of adverse consequences which indicate the dose should be reduced or discontinued; or (6) Any combinations of the reasons stated in paragraphs (d)(1) through (5) of this section. 6
7 Based on comprehensive resident review, the facility must ensure that -- (1) Residents are not given psychotropic drugs unless necessary to treat a specific documented condition; (2) Residents who use psychotropic drugs receive GDRs and behavioral interventions (unless clinically contraindicated) in an effort to discontinue these drugs; (3) Residents do not receive PRN psychotropic drugs unless necessary to treat a specific documented condition; and (4) PRN psychotropic drugs are limited to 14 days if beyond 14 days prescriber documents rationale. (5) PRN antipsychotic orders are limited to 14 days and cannot be renewed unless the prescriber evaluates the resident for appropriateness of the medication. 7
8 Definition (CMS Final Rule dated 10/4/16): Any drug that affects brain activities associated with mental processes and behavior 8
9 Antipsychotics Antidepressants Anxiolytics Sedative-hypnotics CMS has the authority to add other drugs to the definition through sub-regulatory guidance. 9
10 Rule out potentially reversible causes of impaired cognition Delirium, dehydration, electrolyte imbalances, hypothyroidism, pain, constipation, etc. Review of current medications/minimize those that can impair cognition Trial of non-pharmacologic behavior interventions 10
11 chlorpromazine (generic only) fluphenazine (generic only) Haldol (haloperidol) Loxitane (loxapine) Moban (molindone) Navane (thiothixene) perphenazine (generic only) thioridazine (generic only) trifluoperazine (generic only) 11
12 Abilify (aripiprazole) Clozaril (clozapine) Fanapt (iloperidone) Geodon (ziprasidone) Invega (paliperidone) Risperdal (risperidone) Seroquel (quetiapine) Zyprexa (olanzapine) Nuplazid (pimavanserin) Combination antidepressant and atypical antipsychotic medication: Symbyax (Prozac & Zyprexa) fluoxetine & olanzapine 12
13 Identified, documented clinical rationale for administering a medication Based on assessment of the resident s condition + therapeutic goals Consistent with Manufacturer s recommendations and/or clinical practice guidelines Clinical standards of practice Medication references Clinical studies or evidence-based review articles that are published in medical and/or pharmacy journals Source: Appendix PP, F329 13
14 Were other potential causes for the symptoms ruled out? Were physical and/or psychosocial signs, symptoms persistent or significant enough to warrant therapy? Were non-pharmacological interventions tried? Was the medication clinically indicated to manage the symptom or condition? and Does the intended or actual benefit justify the potential risk(s) or adverse consequences associated with the medication, dose, and duration? 14 14
15 Within the first year a resident is admitted on an antipsychotic or after facility has initiated: Facility must attempt GDR in two separate quarters (with at least one month between attempts) unless clinically contraindicated. After the first year: GDR must be attempted annually, unless clinically contraindicated. 15
16 For behavioral symptoms related to dementia: Resident s target symptoms returned/worsened after the most recent GDR attempt within the facility; and The physician has documented the clinical rationale for why any additional attempt at reduction would likely impair the resident s function or increase distressed behavior. 16
17 For psychiatric disorder other than dementia: Continued use is in accordance with relevant current standards of practice and the physician has documented why attempted reduction would be likely to impair function or cause psychiatric instability by exacerbating an underlying psychiatric disorder; or Resident s target symptoms returned/worsened after the most recent GDR attempt within the facility and the physician has documented the clinical rationale for why any additional reduction attempts would be likely to impair the resident s function or cause psychiatric instability by exacerbating an underlying medical or psychiatric disorder. 17
18 Elderly are at increased risk for adverse effects and mortality. Sedation, postural hypotension and falls. Dementia patients should be assessed for type, frequency, severity, pattern and timing of symptoms. Dementia patients should be assessed for pain and other potentially modifiable contributors to symptoms. Comprehensive treatment plan: person-centered nonpharmacological and pharmacological interventions. Nonemergency use of AP only when symptoms severe, dangerous and/or cause significant distress to the patient + assess risk/benefit. If risk/benefit favors use of AP, initiate low dose + titrate to minimum effective dose. If no response after 4-week trial, taper and DC. Source: The American Psychiatric Association Practice Guideline on the Use of Antipsychotics to Treat Agitation or Psychosis in Dementia, Am J Psychiatry 173:5, May
19 Form CMS (7/2015) Has facility met unnecessary medication requirements for each resident? System for monitoring/addressing AE + GDR considerations? Investigation focus (O/I/RR) Critical Elements for citing assessment, care planning, unnecessary meds and MRR Refers to Checklist Care for a Resident with Dementia 19
20 For use with Interpretive Guidance at F309 Key considerations for compliance related to: Assessment and underlying cause identification Care planning Implementation of the care plan Care plan revision/monitoring and follow up Quality assessment and assurance 20
21 21 Utilized during Task 5C resident review In conjunction with Assessment of Drug Therapies Links unnecessary medications with the medication regimen review Identifies s/sx that may be medicationrelated adverse effects (AEs) How did facility assess need + care plan resident medications? Did pharmacist identify actual/potential medication AEs as irregularity during MRR?
22 Survey probes Medical symptoms leading to chemical restraint? Used to restrict function or freedom of movement? Has facility attempted less restrictive alternative? Did resident/representative make an informed choice regarding the medication (risk/benefit/alternatives)? Does facility use the Care Area Assessments to evaluate the appropriateness of the medication? Has facility re-evaluated the need for a chemical restraint? 22
23 CMS S & C Letter NH Issued March 25, 2016 Provided list of F tags with revised guidance to emphasize risk of psychosocial harm Included F329 Draft Revision, highlighting guidance related to how unnecessary medication use can cause psychosocial harm Included language revision in the Psychosocial Outcome Severity Guide (Appendix P) 23
24 May 2012: CMS National Initiative to Improve Dementia Care Goal: reduce NH antipsychotic use by 15% end of 2012 Focus on non-pharmacologic behavior interventions Nursing Home Compare website posted MDS 3.0 QM antipsychotic use data beginning July 2012 Baseline Q4 2011: 23.9% antipsychotic use (L) End of Q2 2016: 16.3% antipsychotic use (L) Relative reduction 31.8% for the time period 24
25 CA Partnership to Improve Dementia Care and Reduce Unnecessary Antipsychotic Use Kick-off stakeholder summit 8/17/12 CMS Region IX (CDPH co-sponsor) Achievements: Baseline (Q4 2011) 21.6% antipsychotic use (L) End of Q2 2016: 12.75% antipsychotic use (L) Relative reduction 40.9% for the time period CA ranks 8 th in the nation (Source: September 2016 CMS data) 25
26 Multiple training programs/materials available for providers, clinicians, consumers and surveyors on the CMS National Nursing Home Quality Improvement Campaign website: spx 26
27 Manufacturer s usage recommendations FDA NIH/DailyMed: Relevant clinical guidelines (partial list) American Psychiatric Association Agency for Healthcare Research and Quality (AHRQ) American Association for Geriatric Psychiatry 27
28 Debra Brown, PharmD, Pharmaceutical Consultant II California Department of Public Health Center for Healthcare Quality/Licensing and Certification Program Phone: (916)
Objectives. Antipsychotics 7/25/2016. LeadingAge Florida 53rd Annual Convention & Exposition
Reducing the Use of Antipsychotics in Long Term Care Communities Alan W. Obringer RPh, CPh, CGP Executive Director Senior Care Pharmacy Objectives Recognize the clinical evidence for the need to change
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 informationClinical Policy: Olanzapine Long-Acting Injection (Zyprexa Relprevv) Reference Number: CP.PHAR.292 Effective Date: Last Review Date: 08.
Clinical Policy: (Zyprexa Relprevv) Reference Number: CP.PHAR.292 Effective Date: 12.01.16 Last Review Date: 08.18 Line of Business: Medicaid See Important Reminder at the end of this policy for important
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Invega Sustenna, Invega Trinza) Reference Number: CP.PHAR.291 Effective Date: 12.01.16 Last Review Date: 08.18 Line of Business: Medicaid See Important Reminder at the end of this policy
More informationHOSPITAL BASED INPATIENT PSYCHIATRIC SERVICES (HBIPS) MEASURE SET
HOSPITAL BASED INPATIENT PSYCHIATRIC SERVICES (HBIPS) MEASURE SET Kathy Wonderly RN, MSEd, CPHQ Consultant Developed: February, 2013 Most recently revised: December 2018 The Psychiatric Measure Set CMS
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Abilify Maintena, Aristada, Aristada Initio) Reference Number: CP.PHAR.290 Effective Date: 12.01.16 Last Review Date: 08.18 Line of Business: Medicaid Coding Implications Revision Log
More informationAntipsychotics Prior Authorization Criteria for Louisiana Fee for Service and MCO Medicaid Recipients
Antipsychotics Prior Authorization Criteria for Louisiana Fee for Service and MCO Medicaid Recipients Preferred Agents (Oral) a Amitriptyline/Perphenazine (Generic) Aripiprazole Tablet (Generic) b Chlorpromazine
More informationPlante Moran Clinical Group
Handouts Prepared By: Jane Belt, MS, RN, RAC-MT Plante Moran Clinical Group jane.belt@ 2 Plante Moran Clinical Group 2013 1 Objectives Delineate the key requirements in F329 Unnecessary Medications Describe
More informationPharmacy Medical Necessity Guidelines: Antipsychotic Medications
Pharmacy Medical Necessity Guidelines: Antipsychotic Medications Effective: July. 1, 2016 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy
More informationAntipsychotic Medications Age and Step Therapy
Market DC *- Florida Healthy Kids Antipsychotic Medications Age and Step Therapy Override(s) Approval Duration Prior Authorization 1 year Quantity Limit *Virginia Medicaid See State Specific Mandates *Indiana
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 informationPharmacy Medical Necessity Guidelines: Antipsychotic Medications
Pharmacy Medical Necessity Guidelines: Effective: April 1, 2018 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED) Benefit
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 informationCOMBATTING THE EXCESSIVE AND ILLEGAL USE OF PSYCHOTROPIC DRUGS ON PEOPLE WITH DEMENTIA IN NURSING FACILITIES
COMBATTING THE EXCESSIVE AND ILLEGAL USE OF PSYCHOTROPIC DRUGS ON PEOPLE WITH DEMENTIA IN NURSING FACILITIES Kelly Bagby and Iris Gonzalez kbagby@aarp.org (202) 434-2103 igonzalez@aarp.org (202) 434-6289
More informationThe Basics of Psychoactive/Psychotropic Medications Tina Sanchez, RN, SMQT New Mexico Department of Health Division of Health Improvement State
The Basics of Psychoactive/Psychotropic Medications Tina Sanchez, RN, SMQT New Mexico Department of Health Division of Health Improvement State RAI/MDS Coordinator Objectives Upon completion of this training,
More informationPresented by Rengena Chan-Ting, DO, CMD, FACOI Jenna D. Toniatti, PharmD
Presented by Rengena Chan-Ting, DO, CMD, FACOI Jenna D. Toniatti, PharmD Define BPSD and review the spectrum of associated symptoms Review pharmacologic and non-pharmacologic treatments for BPSD Evaluate
More informationPharmacy Medical Necessity Guidelines: Atypical Antipsychotic Medications. Effective: February 20, 2017
Pharmacy Medical Necessity Guidelines: Effective: February 20, 2017 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED)
More informationPharmacy Benefit Management (PBM) Program FORMULARY/PRODUCT RESTRICTIONS
Workforce Safety & Insurance Revised Document Date: 07/21/2015 1600 E Century Ave Ste 1 PO Box 5585 Bismarck, ND 58506-5585 701.328.3800 1.800.777.5033 www.workforcesafety.com Pharmacy Benefit Management
More informationPharmacy Medical Necessity Guidelines: Antipsychotic Medications
Pharmacy Medical Necessity Guidelines: Effective: October 1, 2016 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED) Benefit
More informationKelly E. Williams, Pharm.D. PGY2 Psychiatric Pharmacy Resident April 16,2009
Kelly E. Williams, Pharm.D. PGY2 Psychiatric Pharmacy Resident April 16,2009 List the antipsychotics most often prescribed Compare and contrast the use and adverse effects experienced in the pediatric
More information12/17/2012. Unnecessary Drugs
Nursing Home Social Work Webinar Series December 19, 2012 Dr. Robin P. Bonifas, PhD, MSW Arizona State University School of Social Work Importance of familiarity with psychotropic medication regulations.
More informationWhat Team Members Other Than Prescribers Need To Know About Antipsychotics
What Team Members Other Than Prescribers Need To Know About Antipsychotics The Care Transitions Network National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State
More informationAntipsychotic Medications
TRAIL: Team Review of EVIDENCE REVIEW & RECOMMENDATIONS FOR LTC Behavioural and psychological symptoms of dementia (BPSD) refer to the non-cognitive symptoms of disturbed perception, thought content, mood
More informationAntipsychotic Medication
Antipsychotic Medication Mary Knutson, RN 3-7-12 Mosby items and derived items 2009 by Mosby, Inc., an affiliate of Elsevier Inc. 1 Clinical Uses of Antipsychotics Short-term: in severe depression and
More informationWhat would you think?
What would you think? Would you administer a medication to a patient if you were warned by the FDA that by giving it you have increased this resident s risk of death? Strategies in Psychoactive Medication
More informationMedications and Children Disorders
Mental Health Comprehensive Services Providing Family Stability and Developing Life Coping Skills Medications and Children Disorders Psychiatric medications can be an effective part of the treatment for
More informationMaking Sense of the Long Term Care Mega Rule: Unnecessary Drugs & Psychotropics. Session Objectives. January 2018
Making Sense of the Long Term Care Mega Rule: Unnecessary Drugs & Psychotropics Bridget McCrate Protus, PharmD, MLIS, BCGP, CDP Director of Drug Information Optum Hospice Pharmacy Services Session Objectives
More informationAntipsychotics and stroke risk
Integrating Sentinel into Routine Regulatory Drug Review: A Snapshot of the First Year Antipsychotics and stroke risk Lockwood G. Taylor, PhD, MPH Division of Epidemiology II Office of Pharmacovigilance
More informationDrugs requiring prior authorization: the list of drugs requiring prior authorization for this clinical criteria
Drug/Drug Class Antipsychotics Clinical Criteria Information Included in this Document Drugs requiring prior authorization: the list of drugs requiring prior authorization for this clinical criteria Prior
More informationMichael J. Bailey, M.D. OptumHealth Public Sector
Michael J. Bailey, M.D. OptumHealth Public Sector LIHP Quality Charter To ensure the quality of care delivered to enrollees in San Diego County Assistance Programs, such as County Medical Services (CMS)
More informationUpdates to CMS SOM rules on Psychosocial Issues, Deficiency Categorization, and Psychotropic Medication Use
Updates to CMS SOM rules on Psychosocial Issues, Deficiency Categorization, and Psychotropic Medication Use Stephen Eide R. Ph Oni Kinberg LCSW, MSSW Updates to the SOM On March 25, 2016 CMS sent out updates
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 information11/11/2016. Disclosures. Natural history of BPSD. Objectives. Assessment of BPSD. Behavioral Management of Persons with Alzheimer s Disease
Disclosures Behavioral Management of Persons with Alzheimer s Disease Wisconsin Association of Medical Directors November 17, 2016 Art Walaszek, M.D. Professor of Psychiatry UW School of Medicine & Public
More informationSlide 1. Slide 2. Slide 3. About this module. About this module. Antipsychotics: The Essentials Module 5 A Primer on Selected Antipsychotics
Slide 1 Antipsychotics: The Essentials Module 5 A Primer on Selected Antipsychotics Flavio Guzmán, MD Slide 2 About this module 13 antipsychotics will be studied 3 first generation antipsychotics 10 second
More informationTreat Schizophrenia Schizoaffective disorder Bipolar disorder Psychotic depression Off-label uses Insomnia Tics Delirium Stuttering
Robert M. Millay RN MSN Ed Professor, Napa Valley College Psychiatric Technician Programs Copyright 2015, 2011, 2007, 2003, 1999, 1995, 1991 by Mosby, an imprint of Elsevier Inc. Treat Schizophrenia Schizoaffective
More informationRexulti (brexpiprazole)
Market DC Rexulti (brexpiprazole) Override(s) Approval Duration Prior Authorization 1 year Quantity Limit *Indiana see State Specific Mandates below *Maryland see State Specific Mandates below *Virginia
More informationANTIPSYCHOTICS IN LONG TERM CARE: Are We Doing More Harm than Good?
ANTIPSYCHOTICS IN LONG TERM CARE: Are We Doing More Harm than Good? STEPHANIE M. OZALAS, PHARMD, BCPS, BCGP VA MARYLAND HEALTH CARE SYSTEM BALTIMORE, MD DISCLOSURES Off-label use of medications will be
More informationMeasure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety
Measure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety 2017 OPTIONS F INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE
More informationMeasure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety
Measure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY
More informationPharmacy Medical Necessity Guidelines: Atypical Antipsychotic Medications. Effective: December 12, 2017
Pharmacy Medical Necessity Guidelines: Effective: December 12, 2017 Prior Authorization Required Type of Review Care Management Not Covered Type of Review Clinical Review Pharmacy (RX) or Medical (MED)
More informationOBJECTIVES. Achieving Success in Reducing Inappropriate Use of Antipsychotic Medication in Patients with Dementia
Achieving Success in Reducing Inappropriate Use of Antipsychotic Medication in Patients with Dementia Amy J. Osborn, NHA, PMP Executive Director, Health Services Advisory Group (HSAG) Rick Foley, PharmD,
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 informationPsychopharmacology in the Emergency Room. Michael D. Jibson, M.D., Ph.D. Associate Professor of Psychiatry University of Michigan
Psychopharmacology in the Emergency Room Michael D. Jibson, M.D., Ph.D. Associate Professor of Psychiatry University of Michigan Pretest 1. Appropriate target symptoms for emergency room medication treatment
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 informationImproving Dementia Care in Maryland Nursing Homes: A Patient Safety Initiative
Improving Dementia Care in Maryland Nursing Homes: A Patient Safety Initiative March 14, 2014 Susan M. Levy, MD, CMD VPMA Levindale 2 Susan M. Levy, MD-Disclosures VPMA Levindale Physician consultant for
More informationAntipsychotics for Dementia Under Control or Over-Prescribed?
Antipsychotics for Dementia Under Control or Over-Prescribed? Nathaniel Hedrick, PharmD ProCare HospiceCare, Manager of Clinical Services Learning Objectives Summarize the disease progression and most
More informationMEDICAL ASSISTANCE HANDBOOK PRIOR AUTHORIZATION OF PHARMACEUTICAL SERVICES. I. Requirements for Prior Authorization of Antipsychotics
MEDICAL ASSISTANCE HBOOK PRI AUTHIZATION OF PHARMACEUTICAL SERVICES I. Requirements for Prior Authorization of Antipsychotics A. Prescriptions That Require Prior Authorization Prescriptions for Antipsychotics
More informationPsychotropic Medication Use in Dementia
Psychotropic Medication Use in Dementia Marie A DeWitt, MD Diplomate of the American Board of Psychiatry and Neurology, Specialization in Psychiatry & Subspecialization in Geriatric Psychiatry Staff Physician,
More informationTexas Standard Prior Authorization Form Addendum
Texas Standard Prior Authorization Form Addendum Molina Healthcare of Texas Antipsychotics (Medicaid) This fax machine is located in a secure location as required by HIPAA Regulations. Complete / Review
More informationPsychosis, Delirium, Dementia
Psychosis, Delirium, Dementia Melinda M. Spencer Smith, DNP, ACNS-BC, APRN Bertia A. Spencer Jennings, DNP, PPCNP, PMHS, BC Intentions and Limitations of Training Introduction Psychosis, Delirium, Dementia
More information3/11/2014. Welcome. Disclosure. Diagnosing, Interventions and End-of-Life Planning
Diagnosing, Interventions and End-of-Life Planning Welcome We are informing you: The planning committee and faculty have a conflict of interest as they are employees of Great Lakes Caring. They have agreed
More informationREXULTI (brexpiprazole) oral tablet
REXULTI (brexpiprazole) oral tablet Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy
More informationFirst-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness
1 First-Generation Versus Second-Generation Antipsychotics in Adults: Comparative Effectiveness This continuing education monograph examines the results of a comparative effectiveness review to compare
More informationTable of Contents. 1.0 Policy Statement...1
Division of Medical Assistance General Clinical Policy No. A-6 Table of Contents 1.0 Policy Statement...1 2.0 Policy Guidelines...1 2.1 Eligible Recipients...1 2.1.1 General Provisions...1 2.1.2 EPSDT
More informationPolicy Evaluation: Low Dose Quetiapine Safety Edit
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University 500 Summer Street NE, E35, Salem, Oregon 97301 1079 Phone 503 947 5220 Fax 503
More informationDRAFT. Consultees are asked to consider and comment on the CEPP National Audit: Antipsychotics in Dementia document.
Enclosure No: Agenda item No: Author: Contact: xx/xxxxx/xxxx0918 xx CEPP National Audit: Antipsychotics in Dementia All Wales Therapeutics and Toxicology Centre Tel: 02920 71 6900 awttc@wales.nhs.uk 1.0
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 informationAntipsychotics Detect, Select, Effect (P.I.E.C.E.S. 6 th Ed)
Antipsychotics Detect, Select, Effect (P.I.E.C.E.S. 6 th Ed) CLeAR Webinar February 14, 2014 Paula Diaz (Pharm) Carol Ward MD Carol Ward Tertiary Mental Health IHA Hillside Centre (Acute Tertiary Mental
More informationTreat mood, cognition, and behavioral disturbances associated with psychological disorders. Most are not used recreationally or abused
Psychiatric Drugs Psychiatric Drugs Treat mood, cognition, and behavioral disturbances associated with psychological disorders Psychotropic in nature Most are not used recreationally or abused Benzodiazepines
More informationDisclosure. Speaker Bureaus. Grant Support. Pfizer Forest Norvartis. Pan American Health Organization/WHO NIA HRSA
Disclosure Speaker Bureaus Pfizer Forest Norvartis Grant Support Pan American Health Organization/WHO NIA HRSA How Common is Psychosis in Alzheimer s Disease? Review of 55 studies 41% of those with Alzheimer
More informationA Brief Overview of Psychiatric Pharmacotherapy. Joel V. Oberstar, M.D. Chief Executive Officer
A Brief Overview of Psychiatric Pharmacotherapy Joel V. Oberstar, M.D. Chief Executive Officer Disclosures Some medications discussed are not approved by the FDA for use in the population discussed/described.
More informationComparison of Atypical Antipsychotics
PL Detail-Document #281006 This PL Detail-Document gives subscribers additional insight related to the Recommendations published in PHARMACIST S LETTER / PRESCRIBER S LETTER October 2012 Comparison of
More informationUsing Drugs to Improve the Behavior of People with Autism: A Skeptical Appraisal. Alan Poling, Ph.D., BCBA-D Western Michigan University
Using Drugs to Improve the Behavior of People with Autism: A Skeptical Appraisal Alan Poling, Ph.D., BCBA-D Western Michigan University In a 2010 study of 60,641 children Mandell et al. found that: 56%
More informationINJECTABLE ANTIPSYCHOTICS AUTHORIZATION FORM
SUBMIT TO Utilization Management Department Phone: 1.866.912.6285 Fax: 1.866.694.3649 MEMBER INFORMATION INJECTABLE ANTIPSYCHOTICS AUTHORIZATION FORM Fax completed form to Cepatico at 866.694.3649. Upon
More informationPSYCHIATRIC DRUGS. Mr. D.Raju, M.pharm, Lecturer
PSYCHIATRIC DRUGS Mr. D.Raju, M.pharm, Lecturer PSYCHIATRIC DRUGS Treat mood, cognition, and behavioral disturbances associated with psychological disorders Psychotropic in nature Most are not used recreationally
More informationGuidelines for the Management of Behavioural and Psychological Symptoms of Dementia (BPSD) Summary document for Primary Care
Guidelines for the Management of Behavioural and Psychological Symptoms of Dementia (BPSD) Summary document for Primary Care Guidelines for the Management of Behavioural and Psychological Symptoms of Dementia
More informationProposed Changes to Existing Measure for HEDIS : Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
Proposed Changes to Existing Measure for HEDIS 1 2020: Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA) NCQA seeks comments on proposed modifications to the HEDIS Health
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Invega) Reference Number: CP. PMA.10.11.19 Effective Date: 10.06.16 Last Review Date: 04.18 Line of Business: CenpaticoMedicaid Revision Log See Important Reminder at the end of this
More informationPSYCHOTROPIC MEDICATIONS IN LTC CHALLENGES AND OPPORTUNITIES FOR BEST PRACTICES
PSYCHOTROPIC MEDICATIONS IN LTC CHALLENGES AND OPPORTUNITIES FOR BEST PRACTICES Coleen Kayden, RPh Medication Information Services Division of Williams Apothecary Conflicts of Interest None to report PANAC
More informationPreferred Prescribing Choices of Antipsychotic Drugs (APD) in Adults for Schizophrenia and Other Psychoses
Preferred Prescribing Choices of Antipsychotic Drugs (APD) in Adults for Schizophrenia and Other Psychoses HPFT Medicines Formulary lists the APDs that have been approved for use, however, it does not
More informationDEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017.
DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017. Introduction. Parkinson's disease (PD) has been considered largely as a motor disorder. It has been increasingly recognized that
More informationObjectives. Epidemiology. Diagnosis 3/27/2013. Identify positive and negative symptoms used for diagnosis of schizophrenia
Objectives Identify positive and negative symptoms used for diagnosis of schizophrenia Mohamed Sallout, Pharm D. Pharmacist Resident St. Luke s Magic Valley Regional Medical Center List medications used
More informationDementia Care Principles
New CMS Surveyor Guidance: Care & Services for a Resident with Dementia Cat Selman, BS www.thehealthcarecommunicators.com 2015 The Healthcare Communicators, Inc. All rights reserved. Dementia Care Principles
More informationDelirium. Assessment and Management
Delirium Assessment and Management Goals and Objectives Participants will: 1. be able to recognize and diagnose the syndrome of delirium. 2. understand the causes of delirium. 3. become knowledgeable about
More informationPsychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias. Aaron H. Kaufman, MD
Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias Aaron H. Kaufman, MD Psychiatric and Behavioral Symptoms in Alzheimer s and Other Dementias Aaron H. Kaufman, M.D. Health Sciences
More informationSupplementary Online Content
Supplementary Online Content Huybrechts KF, Hernández-Díaz S, Patorno E, et al. Antipsychotic use in pregnancy and the risk for congenital malformations. JAMA Psychiatry. Published online August 17, 2016.
More informationRiding the Waves: Tools for the Management of Bipolar Disorder
Riding the Waves: Tools for the Management of Bipolar Disorder Jacintha S. Cauffield, Pharm.D., BCPS, CDE Associate Professor of Pharmacy Practice Palm Beach Atlantic University Lloyd L. Gregory School
More informationNew England QIN-QIO Reducing Unnecessary Antipsychotic Medications Affinity Group Call Thursday, January 19 th 3-4:00 pm. Presenters.
New England QIN-QIO Reducing Unnecessary Antipsychotic Medications Affinity Group Call Thursday, January 19 th 3-4:00 pm Call-In Information: 1-888-895-6448 Code: 7362894 Log-In Information: https://qualidigm.adobeconnect.com/affinity/
More informationAntipsychotic Use in the Elderly
Antipsychotic Use in the Elderly Presented by: Fatima M. Ali, PharmD, RPh, BCPS Clinical Consultant Pharmacist MediSystem Pharmacy, Kingston Originally Prepared by: Nicole Tisi BScPhm, RPh ACPR Disclosure
More informationChapter 17. Psychoses. Classifications of Psychoses. Schizophrenia. Factors Attributed to Development of Psychoses
Chapter 17 Psychoses Drugs for Psychoses Delusions Hallucinations Illusions Paranoia Upper Saddle River, New Jersey 07458 All rights reserved. Classifications of Psychoses Acute episode Chronic episode
More informationThis factsheet covers:
Antipsychotics If you experience psychosis as part of your illness, you may be offered antipsychotic medication. Antipsychotics are generally used to treat psychosis, but are also used to treat bipolar
More informationAbbreviated Class Review: Long-Acting Injectable Antipsychotics
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationMedication Treatment of Cognitive and Behavioral Symptoms in Dementia
Medication Treatment of Cognitive and Behavioral Symptoms in Dementia Cary J. Kohlenberg, M.D. Medical Director, IPC Research and Independent Psychiatric Consultants Environmental interventions directly
More informationMr. E, age 37, has a 20-year history
Antipsychotics for obsessive-compulsive disorder: Weighing risks vs benefits Taylor Modesitt, PharmD, Traci Turner, PharmD, BCPP, Lindsay Honaker, DO, Todd Jamrose, DO, Elizabeth Cunningham, DO, and Christopher
More informationFull details and resource documents available:
Clinical & Regulatory News by Pharmerica Urinary Tract Infection (UTI) Second Most Common Cause of Hospital Readmission within 30 days UTIs are prevalent and account for up to 22% of infections in LTC,
More informationAtivan and geodon compatibility
P ford residence southampton, ny Ativan and geodon compatibility In this case, a patient developed severe hypotension (66/30 mm Hg) after receiving intramuscular olanzapine and intramuscular lorazepam
More informationAbbreviated Class Review: Long-Acting Injectable Antipsychotics
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationAppendix: Psychotropic Medication Reference Tables
Appendix: Psychotropic Medication Reference Tables How to Use these Tables These reference tables are designed to provide clinic staff with specific medication related criteria for the Polypharmacy, Cardiometabolic
More informationIncreasing off-label use of antipsychotic medications in the United States,
high cost, 1 as well as concerns regarding their safety, 2 comparative efficacy, 3 and off-label use in the absence of strong evidence. 4 Atypical antipsychotics accounted for more than $13 billion dollars
More informationUse of Psychotropic Medications in Older Adults with Dementia!
Use of Psychotropic Medications in Older Adults with Dementia! Deepa Pattani, PharmD, RPh Owner: PrevInteract Health Deepa.Pattani@PrevInteract.com 972-372-9775 About Me Deepa Pattani, PharmD, RPh with
More informationHigh Dose Antipsychotic Therapy (HDAT) guideline
Document level: Trustwide (TW) Code: MP18 Issue number: 2 High Dose Antipsychotic Therapy (HDAT) guideline Lead executive Medical Director Author and contact number Lead Clinical Pharmacist 01625 663 857
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Vraylar) Reference Number: CP.PMN.91 Effective Date: 11.16.16 Last Review Date: 02.18 Line of Business: Commercial, Medicaid Revision Log See Important Reminder at the end of this policy
More informationPsychosis and Agitation in Dementia
Psychosis and Agitation in Dementia Dilip V. Jeste, MD Estelle & Edgar Levi Chair in Aging, Director, Stein Institute for Research on Aging, Distinguished Professor of Psychiatry & Neurosciences, University
More informationPharmacological Treatment of Behavioural and Psychological Symptoms of Dementia (BPSD) Gurdeep K Major St. Charles Hospital
Pharmacological Treatment of Behavioural and Psychological Symptoms of Dementia (BPSD) Gurdeep K Major St. Charles Hospital with thanks to Jonathan Cavan for his input Aims Define BPSD and common symptoms
More informationClass Update: Oral Antipsychotics
Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119
More informationLATUDA Commercial Update
LATUDA Commercial Update LATUDA Meeting (Tokyo) January 2011 Mark Iwicki President and Chief Operating Officer Sunovion Pharmaceuticals Inc. Sunovion Is Uniquely Positioned to Deliver Strong Performance
More informationIntegrating INTERACT into Interim Pharmacist Reviews
Integrating INTERACT into Interim Pharmacist Reviews Chad R. Worz, Pharm.D. President, Medication Managers, LLC Adjunct Assistant Professor of Pharmacy Practice, University of Cincinnati, College of Pharmacy
More informationIMPORTANT NOTICE. Changes to dispensing of some Behavioral Health Medications for DC Healthcare Alliance members
IMPORTANT NOTICE Changes to dispensing of some Behavioral Health Medications for DC Healthcare Alliance members These changes apply only to members covered under the DC Healthcare Alliance program Alliance
More information