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Missouri Behavioral Pharmacy Management Program Receives 2008 SAMHSA Science and Service Award

JEFFERSON CITY, Mo., Dec. 17 /PRNewswire/ -- The Missouri Behavioral Pharmacy Management Program (BPM) has been selected by the Substance Abuse and Mental Health Services Administration (SAMHSA) to receive one of their prestigious 2008 Science and Service Awards. These awards "recognize exemplary implementation of evidence-based interventions that have been shown to prevent and/or treat mental illnesses and substance abuse"(1).

The program is a partnership between the Missouri Department of Mental Health, the Missouri Department of Social Services - MO HealthNet Division, and Comprehensive NeuroScience, Inc. (CNS). Eli Lilly and Company provided funding for the initial pilot project. John Docherty, M.D., founder and CEO of CNS, a national clinical research company, remarked, "We are pleased that SAMHSA has recognized this program as innovative and a sound practice in the treatment of mental illness."

For the past five years, the BPM has been improving the psychiatric medication prescribing practices of thousands of Missouri physicians. Using extensive pharmacy data mining and the application of rigorously developed Quality Indicators(TM), the BPM focuses on prescribers who practice outside of evidence-based or best practice standards including areas such as prescribing multiple medications from the same therapeutic class, prescribing above or below recommended dosing levels, or premature or rapid switching from one medication to another. In addition, providers are also alerted to instances of 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-rich educational mailing aims to impart knowledge of best practices in pharmacotherapy for mental and behavioral health disorders. It offers prescribers clear, simple suggestions for improving the quality of treatment, as well as carefully crafted Clinical Considerations based on published literature or consensus expert opinion." Physicians who continue to experience the same issues over time are offered a peer consultation to discuss prescribing practices.

A voluntary program, the BPM protects patient-physician autonomy in making individual clinical decisions, and it avoids unintended consequences of other more intrusive or aggressive cost-containment strategies(2) while still showing a positive impact on not just costs but on quality of care. As a result, Missouri has realized better treatment adherence, reduced inappropriate medication usage, and reduced hospitalizations for many thousands of patients, resulting in millions of dollars saved in healthcare costs.

"This is a model on how states can increase the quality of care that Medicaid residents with severe mental illnesses receive while encouraging more efficient use of taxpayer dollars," said Joseph Parks, M.D., Medical Director of Missouri's Department of Mental Health. "Through this project, many opportunities for coordination of care have been identified, resulting in improved quality of care and enhanced quality of life for persons with mental illness."

George Oestreich, Pharm.D., MPA, Deputy Director of MO HealthNet, agrees: "You really have to look at the total healthcare impact to understand what a difference improving quality can make. We know that educating physicians on prescribing patterns for drugs that treat mental illness is an excellent way to improve the overall quality of mental health treatment within our Medicaid program."

The Missouri BPM averages 1,900 adult and child prescriber interventions and 7,400 patients touched per month. In addition, based on the Missouri model and results, BPM is now operating in 22 state Medicaid agencies and has also been expanded to Medicare and commercial markets.

(1) SAMHSA Announces 2008 Science and Service Award Winners, October 22, 2008 News Release.

(2) Ning A, Dubin WR, Parks JJ. Pharmacy costs: Finding a role for quality. Psychiatric Services, 2005; 56:909-11.

SOURCE The Missouri Behavioral Pharmacy Management Program
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