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Project Information

ADVANCING PATIENT SAFETY FOR ANTIPSYCHOTIC-TREATED CHILDREN: EXAMINING STATE IMPLEMENTATION OF SAFE USE PRACTICES

Agency:
AHRQ

HHS/Agency for Healthcare Research and Quality

Project Number:
1R01HS026001-01A1
Contact PI / Project Leader:
CRYSTAL, STEPHEN
Awardee Organization:
RUTGERS THE ST UNIV OF NJ NEW BRUNSWICK

Description

Abstract Text:
This project will address, at scale, improvement of safe use practices for antipsychotic (AP) treatment of Medicaid children. Safe and judicious management of APs poses significant challenges, given hazards that include elevated risk of Type 2 diabetes, weight gain, hyperglycemia, hyperlipidemia, and potential long-term impact on brain development. Safety evidence and guidelines highlight the importance of several key safe-use practices that can help mitigate these risks, including monitoring blood glucose and lipids; avoiding concurrent use of multiple different APs; first-line use of non-pharmacological mental health services; and minimizing use among pre-school children. Prior AHRQ-supported projects have led to HEDIS/CMS quality metrics for these practices, but their implementation is highly inconsistent. Many state initiatives have been implemented to improve these safe-use practices, but the impact of alternative strategies for increasing safe-use is unknown. Evidence on their effects is critically needed. We will use a mixed-methods strategy to identify and document state implementation of safe-use initiatives; assess their impact on safe use metrics; investigate causal mechanisms underlying effectiveness; and actively disseminate results to state decisionmakers, health plans, clinical communities, and other stakeholders. This process will support translation, implementation, and improvement of effective strategies across states. We will provide a comprehensive analysis of systems-level strategies, using a national survey and case studies in 8 purposively sampled states, to investigate distinctive approaches. We will use key informant interviews and systematic document review to identify implementation timelines, strategies, causal mechanisms, barriers and solutions, and tools utilized. We will then use Medicaid claims data to assess change in the use of the targeted practices following the implementation of state systems-level strategies, using difference-in-difference, triple-difference and other modeling strategies. States that did not implement similar initiatives will serve as comparators. Finally, we will actively disseminate an evidence-informed toolkit to state and stakeholder communities, utilizing active dissemination strategies successfully employed in prior AHRQ-supported partnerships. This toolkit will be developed to facilitate a self- assessment and prioritization of improvement initiatives, identification of other state strategies, and provide quality improvement and evaluation tools to assess effectiveness over time. Evidence development and active dissemination will assure that evidence on effective system-improvement processes is available, understood, and effectively used to improve patient safety across populations of vulnerable children served by state Medicaid/CHIP systems and reduce AP-related harms.
Project Terms:
No terms available

Details

Contact PI / Project Leader Information:
Name:  CRYSTAL, STEPHEN
Other PI Information:
Not Applicable
Awardee Organization:
Name:  RUTGERS THE ST UNIV OF NJ NEW BRUNSWICK
City:  PISCATAWAY    
Country:  UNITED STATES
Congressional District:
State Code:  NJ
District:  06
Other Information:
Fiscal Year: 2018
Award Notice Date: 24-Sep-2018
DUNS Number: 001912864
Project Start Date: 30-Sep-2018
Budget Start Date: 30-Sep-2018
CFDA Code: 226
Project End Date: 31-Jul-2023
Budget End Date: 31-Jul-2019
Agency: ?

Agency: The entity responsible for the administering of a research grant, project, or contract. This may represent a federal department, agency, or sub-agency (institute or center). Details on agencies in Federal RePORTER can be found in the FAQ page.

HHS/Agency for Healthcare Research and Quality
Project Funding Information for 2018:
Year Agency

Agency: The entity responsible for the administering of a research grant, project, or contract. This may represent a federal department, agency, or sub-agency (institute or center). Details on agencies in Federal RePORTER can be found in the FAQ page.

FY Total Cost
2018 AHRQ

HHS/Agency for Healthcare Research and Quality

$396,887

Results

i

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