Document Detail


Administrative prescription review procedures and use of atypical antipsychotic medications in the Department of Veterans Affairs.
MedLine Citation:
PMID:  15224448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atypical antipsychotic medications vary in cost with limited evidence of differences in effectiveness. Administrative prescription review has been proposed as a way of encouraging use of less expensive medication when there is no specific clinical justification for using more expensive medication. This study examined data from a national GAO survey of 876 veterans affairs (VA) psychiatrists, and national administrative data on the proportion of veterans actually receiving atypical antipsychotic medications. The proportion of psychiatrists in each region reporting that they did not feel free to prescribe expensive drugs when indicated was negatively correlated with the proportion of patients who filled prescriptions for clozapine, the most expensive atypical. The proportion reporting review procedures for prescribing olanzapine was significantly and negatively correlated with the proportion of veterans actually receiving prescriptions for olanzapine and, positively associated with the proportion prescribed risperidone. Nondirective administrative review procedures in VA are significantly associated with actual prescribing patterns and may generate modest cost savings in the prescription of atypical antipsychotic medication.
Authors:
Robert Rosenheck; Douglas Leslie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Mental health services research     Volume:  5     ISSN:  1522-3434     ISO Abbreviation:  Ment Health Serv Res     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2004-06-30     Completed Date:  2004-07-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9815815     Medline TA:  Ment Health Serv Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  149-53     Citation Subset:  IM    
Affiliation:
Yale Departments of Psychiatry and Epidemiology and Public Health, New Haven, Connecticut, USA. robert.rosenheck@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Antipsychotic Agents / economics,  therapeutic use*
Cost Control
Data Collection
Decision Making
Drug Utilization Review*
Female
Humans
Male
Psychopharmacology
Schizophrenia / drug therapy*
United States
United States Department of Veterans Affairs*
Chemical
Reg. No./Substance:
0/Antipsychotic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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